What is Neuro-optometry?
Neuro-optometry is a subfield of optometry that evaluates patients with visual complaints and double vision secondary to physical disabilities, acquired brain injury (concussion, trauma, stroke, etc) and/or neurological disease (Parkinson's disease, multiple sclerosis, myasthenia gravis, Lyme disease, etc).
Neuro-optometric rehabilitation is the individualized treatment plan for patients that may have acquired strabismus (eye turns), diplopia (double vision), binocular vision dysfunction, convergence insufficiency, convergence and/or accommodation paresis/paralysis/spasm, oculomotor dysfunction, visual-spatial dysfunction, visual perceptual deficits, and neurologic visual acuity and/or visual field loss
How is a Neuro-optometric exam different from a routine eye exam?
The neuro-optometric examination is a comprehensive and problem-focused evaluation of all the aspects of vision that may be affected by damage to the eyes and central nervous system. This assessment will include elements of the traditional eye exam including ocular health, evaluation of visual acuity (clarity), peripheral vision, and refractive error (glasses prescription).
The traditional eye exam can be done first by your primary eye care provider if you prefer. We are happy to and encourage co-management with your primary optometrist/ophthalmologist
Depending on the visual concern, the neuro-optometric evaluation will employ advanced testing to evaluate how the eyes work together (sensory-motor/oculomotor), and how the brain interprets what the brain sees (visual processing).
What kind of treatment options are available?
Every individual is different. Your treatment depends upon your diagnosis and your personal goals. Our mission is to get you to do and see the things you enjoy. Outside of the neuro-optometric testing, a majority of the time is spent understanding your individual needs and goals, and discussing what would be the best treatment plan for you.
Treatment options may include but are not limited to
Prism glasses to help double vision, gaze limitations, visual field restrictions
Tinted lenses for patients with contrast sensitivity loss and/or light sensitivity
Vision Therapy and Neuro-Optometric Vision Rehabilitation
Adaptation rehabilitation - education on how to adapt one's environment to their visual deficit
Remediation rehabilitation - vision therapy to actually fix the visual deficit
Concussion and traumatic brain injury vision therapy
Orthoptics (oculomotor) vision therapy for Convergence insufficiency, Convergence Spasm, and Accommodative disorders
Compensation rehabilitation - vision therapy to enable a patient to use their stronger/normal visual skills to compensate for their relatively weaker visual skills
What is the difference between a residency-trained and a fellowship-trained neuro-optometrist?
All optometrists must graduate from a four-year accredited post-graduate optometry school and pass a national board exam demonstrating competency in primary care optometry. After optometry school, an optometrist can apply for a residency program, which is an additional intensive year of postdoctoral advanced training dedicated to a subfield of optometry such as neuro-optometry, pediatrics, contact lenses, low vision or ocular disease. Residency training is completed in a university, veterans affairs, or hospital setting, and is formalized to ensure that the training is evidence-based and accepted as standard medical care. Like medical residency programs, these residencies are competitive and require rigorous clinical education that is regulated by ASCO (Association of Schools and Colleges of Optometry)
Some optometrists with or without residency training, can also apply for a membership/fellowship to a private optometric organization that can enhance their skill set in one of the sub-fields of optometry for example behavioral or developmental or functional optometry. While these programs are not accredited, year-long intensive training programs like residencies, they do provide enhanced training and continuing education programs for optometrists who want to enhance their skill set and provide additional services to their patients. They also provide the optometrist with opportunities for lifelong learning to make sure they are up-to-date with changes in their field. Examples of organizations an optometrist can apply for membership/fellowship to include the Neuro-Optometric Rehabilitation Organization (NORA) or the American Academy of Optometry (AAO), just to name a few.
Dr. Theis is residency-trained in neuro-optometry, children's vision, and binocular vision, she is a fellow of the American Academy of Optometry, and a proud member of the Virginia Optometric Association, American Optometric Association, and Neuro-Optometric Rehabilitation Organization. She also has done clinical research in post-traumatic/post-concussion oculomotor dysfunction and sports vision performance in collegiate and professional athletes, and continues to do researchin eye movements in neurologic disease and brain injury. Dr. Theis also serves on the American Optometric Association Vision Rehabilitation Committee and Evidence-Based Optometry Committees, ensuring quality practice within the profession.