Brain Injury Recovery Therapy
San Diego Center for Vision Care – Optometry, PC – the Center for Visual Rehabilitation after Brain Injury
Two Thirds of all the nerves that enter the brain originate from the eyes. When there is injury, there is often disruption of visual processing.
The four most common visual problems that result from brain injury (stroke, tumor, trauma etc) are:
- Double Vision
- Loss Of Visual Field (unable to see to the right or left)
- Balance disorders (miss-judging visual space relative to the body)
- Visual Information Processing Dysfunction
Visual Rehabilitation can help people overcome these devastating visual problems. One can often recover the ability to do things that they have always done themselves such as driving and reading.
Close coordination between Occupational Therapy, Physical Therapy, Speech Therapy, Neuro-Psychology, Neuro-Otology and your Physician allows for the best team approach toward recovery.
Testing involves:
- Visual acuity testing
- Refractive analysis
- Eye-movement control
- Eye-alignment testing
- Focusing ability
- Peripheral Vision
- Spatial awareness testing
- Eye-health evaluation
- Visual perceptual testing
- Photic Sensitivity – Tinted lens testing
- Evaluation of visually guided movement
Treatment for double vision may involve the use of a Fresnel prism to redirect light into the turned eye, so as to eliminate the double vision.
Loss of visual field is often treated with the use of a “field awareness prism”, it is like a “picture-in-picture” television, in that visual information from the non-seeing field is moved into the seeing field so that there is awareness of visual information in the otherwise blind visual field.
For balance, the use of “yoked prism” can re-align the balancing system of the body with the visual system, providing for much more confident visually guided movement.
Photophobia, the aversion to bright or flickering light or environmental movement is often resolved by controlling the light entering the visual system. Modifying environmental light, or controlling the light entering the eye with very specific colored lenses can often do this. Colorimeter tints are often used as therapeutic lenses.
Visual Information processing dysfunction is treated with neuro-adaptive learning as well as with perceptual learning. Two thirds of the input to the brain originates from the eyes. Neuro-adaptive learning arranges for individuals to learn how to coordinate this input into the brain by learning to coordinate the muscles of the eyes. Once one learns to do this efficiently, then therapy progresses to perceptual learning; that is, learning how to accurately perceive the information that arrives from the eyes to the brain. This requires integrating and matching and coordinating information from all of the senses. This is done by having patients engage in activities that surround visual discrimination (size, shape, area) and pattern recognition (linear and spatial), while processing vestibular and auditory input. Finally, visual cognition (attention, thinking, memory) is developed by coordinating these previously learned skills with more complex activities.
Prior to the initial evaluation, a 4-page questionnaire is reviewed, as well as any previous available medical records. The first visit requires 1hour and 15 minutes of examination time. After this appointment, the results are reviewed and a report is written. A conference is scheduled to review the results of the evaluation.