Skip to main content


neuro_tbi

Post Traumatic Vision Syndrome

Home »

Post-Traumatic Vision Syndrome

An astounding 2.8 million Americans suffer traumatic brain injuries (TBI) each year, of which the majority are mild brain injuries (i.e. concussions). In 9 out of 10 cases, concussions and other traumatic brain injuries result in some degree of visual dysfunction, as nearly half of the brain is dedicated to vision-related processing. The collective symptoms of visual disturbances following a head injury are referred to as post-traumatic vision syndrome (PTVS). Neuro-optometric rehabilitation helps to restore pathways in the eye-brain connection and reduce PTVS symptoms.

If you or a loved one have suffered a traumatic brain injury, contact to learn how neuro-rehabilitation therapy can provide visual recovery.

What Is Post-Traumatic Vision Syndrome?

Trauma to the brain’s cortex stresses the central and autonomic nervous systems. This affects vision and interferes with the visual process and sensory-motor feedback loop.

There are two aspects of vision that, in a healthy person, interact seamlessly for clear vision: central vision and peripheral/spatial vision. Those with PTVS will experience difficulty connecting the two systems, resulting in one or several visual disturbances and symptoms.

man in black tshirt

What Are the Symptoms of PTVS?

Even with 20/20 vision, a concussed patient may experience visual dysfunctions, such as:

  • Eyestrain, especially while reading or using the computer
  • Double vision
  • Blurred vision
  • Low blink rate
  • Depth-perception issues
  • Sensitivity to light (photophobia)
  • Difficulty with eye-tracking

Non-visual symptoms include:

  • Headaches
  • Dizziness
  • Difficulty reading
  • Poor balance
  • Difficulty navigating through crowded or tight spaces
  • Visual memory problems
  • Difficulty concentrating
  • Disorientation
  • Driving difficulties

How Does a Neuro-Optometrist Treat PTVS?

Neuro-optometric rehabilitation is the process where a specially trained optometrist helps the patient improve any visual skills that have been reduced due to brain trauma. The neuro-optometrist will diagnose ocular health and assess a wide range of visual abilities, including:

  • Functional binocularity
  • Spatial awareness
  • Visual processing skills
  • Eye-tracking and focusing
  • Convergence
  • Ocular motor function
  • Visual midline shift

After diagnosis, the doctor will formulate a highly personalized treatment strategy that may include the use of specialty lenses, prisms, and other visual aids to rehabilitate vision.

Treatment time ranges from a number of weeks to over a year, depending on the degree of visual dysfunction and patient compliance. Since the visual system is connected with other bodily systems, an interdisciplinary and cooperative approach with other health care professionals is ideal for optimal results.

It’s crucial to get treatment for PTVS as soon as possible to minimize any struggles and regain pre-injury quality of life. For more information or to schedule a consultation, call today.

References

Traumatic Brain Injury Rehabilitation

Home »

Traumatic Brain Injury Rehabilitation

The statistics on TBIs are quite startling. Over 2.8 million Americans suffer a form of traumatic injury each year, which is close to 1 in 100. Traumatic brain injury causes damage to the brain, resulting in headaches, confusion, poor concentration, and vision dysfunctions, among other problems. Fortunately, vision rehabilitation treatment, as part of an integrated team approach, can effectively help in the rehabilitation of patients with traumatic brain injuries.

What Is a Traumatic Brain Injury?

Traumatic brain injury (TBI) occurs when a sudden injury damages your brain. There are two types of TBI: a closed head injury that doesn’t break through the skull (yet may still cause brain damage), and a penetrating head injury, which causes the skull to break.

Approximately 47% of traumatic brain injuries are caused by falls, particularly among young children and those over 65 years of age. Other TBI injuries can result from blunt force trauma (15%), car accidents (14%), and violent physical assaults (9%).

The symptoms experienced following a TBI include headaches, confusion, dizziness, convulsions, poor concentration, memory issues, and personality changes. Because more areas of the brain are used to process vision than any other system, traumatic brain injuries can often result in vision problems.

In order to recover from a TBI, one needs to undergo rehabilitation, which can come in many forms — depending on your specific case and requirements. It may include physical, occupational, and speech therapy, as well as neurological, and psychiatric care. Neuro-optometric rehabilitation, however, is one of the most effective ways to resolve a range of traumatic brain injury vision problems.

Rehabilitation for Traumatic Brain Injuries

kissing wifeDuring its acute stage, moderately to severely injured TBI patients will typically be treated and cared for in the intensive care unit of a hospital. As your needs and abilities change, so will the rehab program. Rehabilitation can take place in various settings, such as inpatient or outpatient rehab hospitals, home-based rehab, day programs, and independent living centers.

What Does Rehabilitation Resemble Following Brain Injury?

Everybody’s needs and functions vary following a brain injury, and each rehab program is designed to match the patient’s unique needs and goals. The program generally includes a case coordinator and several healthcare providers.

The treatments below are offered based on your functions and abilities, such as visual skills, speech ability, mental and behavioral state, language comprehension, among others.

  • Physical therapy
  • Physical medicine
  • Occupational therapy
  • Neuro-optometric rehabilitation
  • Psychiatric and psychological care
  • Speech and language therapy

How Does TBI Affect Vision?

Studies indicate that 90 % of TBI patients experience some form of vision disruption, which is caused by interrupted communication between the eyes and the brain.

Symptoms include:

  • Blurred vision
  • Eyestrain
  • Increased sensitivity to light (photophobia)
  • Reading difficulties
  • Visual periphery defects
  • Color contrast issues
  • Vestibular dysfunction
  • Decreased visual acuity

These visual aberrations may affect professional, educational and other aspects of daily living.

Unfortunately, TBI-related vision problems may often be overlooked during the initial brain injury treatment as visual disruptions may not be present until some time has passed following the accident.

holding handsHow Can an Optometrist Help in the Recovery of a TBI?

Optometrists, who typically work as part of an interdisciplinary team, play a crucial role in treating patients with TBI. Neuro- optometric rehabilitation optometrists (neuro-optometrists) assess and treat TBI-related visual disorders that impact the patient’s rehabilitative progress and quality of life.

At , we see a variety of patients who have had TBI, whether due to a sports injury, motor vehicle accident, or fall, with visual problems range in complexity and severity. By staying on top of the most recent research, can properly tailor a treatment plan to the patient’s unique needs for maximum results.

Two Types of Eye Doctors Specialize in the Detection and Treatment of TBI

Neuro-optometrists

A neuro-optometrist is a Doctor of Optometry (OD) who is highly trained in diagnosing and treating neurological conditions that impact the visual system. The treatment of TBI by a neuro-optometrist is called neuro-optometric rehabilitation (also known as vision rehabilitation).

Neuro-optometric rehabilitation should not be confused with vision therapy, as not all doctors who offer vision therapy are trained in neuro-optometric rehabilitation.

Neuro-ophthalmologist

A neuro-ophthalmologist is a medically trained eye doctor ( MD) who specializes in vision problems relating to the nervous system — such as TBI-related visual acuity loss.

Both neuro-optometrists, such as , and neuro-ophthalmologists can identify TBI-related vision problems. Depending on the type and severity of problems detected, they will develop a treatment plan uniquely designed to eliminate post-TBI vision symptoms and difficulties. Treatments typically include specialized glasses to help with visual processing or in-office and at-home neuro-rehabilitation procedures to reduce symptoms and promote visual recovery.

It is important to note that a single type of vision rehabilitation treatment is often not enough to address all the patient’s needs. That is why an interdisciplinary, integrated team approach can play a vital role in the rehabilitation of patients with traumatic brain injuries.

Neuro-Optometric Rehabilitation for Brain Injuries

Neuro-Optometric Rehabilitation is a personalized treatment regimen for those with visual deficits resulting from traumatic brain injuries, physical disabilities or other neurological issues. The vision complications that develop following a TBI are not related to visual acuity (20/20) but rather to eye teaming, focusing, and tracking. This can result in difficulties in reading and playing sports.

The goal of neuro-optometric rehabilitation is to retrain the visual system and eliminate the visual symptoms that arise from a traumatic brain injury. Fortunately, by using specific eye-training exercises, one can rewire the brain to improve eye function. Just as with other rehabilitation methods, the earlier one starts the eye exercises following a TBI, the better the chance of recovery and sight improvement.

We will use a variety of tools and exercises to train aspects of the visual system in order to improve vision accuracy. The functional skills the doctor will work on will include eye tracking, focusing, and eye teaming, as well as visual discrimination (the ability to discern b’s and d’s), handwriting, and spatial awareness. During the course of the treatment, the patient will be assigned a series of home exercises with specialized equipment. Follow-ups will be regularly scheduled by the optometrist to assess progress.

Should Everyone With a Brain Injury See An Eye Doctor?

If you experience a traumatic brain injury, make sure to see a neuro-optometrist who has special training in TBI-related visual aberrations. This is all the more necessary if you experience any changes in your vision following head trauma.

Children With Traumatic Brain Injury

Though the symptoms of TBI in children resemble those experienced by adults, the functional impact can be very different. Because the brain of a child is in development, a brain injury can result in cognitive impairments. Though not always apparent following the injury, it may manifest itself as the child gets older. Your child may face physical, cognitive, and emotional challenges which can result in struggles for children, their families, schools, and communities.

Therefore, once the child is stabilized following a brain injury, the patient should receive physical therapy, occupational therapy, speech therapy, optometric and neuropsychological testing. Rehabilitation will teach the child how to compensate for impaired or lost functions and will provide strategies on ways to optimize the use of these abilities as they return.

The caring and knowledgeable staff at are always here to help patients experience the best vision care and treatment possible.

ImPACT Concussion Testing 1280

Home »

ImPACT Concussion Testing

A concussion is the most common type of traumatic brain injury (TBI). Every concussion is different; symptoms and recovery depend on the nature of the injury, the patient’s age, and overall health, among other factors.

One of the best ways to evaluate a person’s brain health is by comparing post-concussion brain function with pre-concussion brain function. ImPACT concussion testing provides before and after comparisons that measure your memory, reaction time, and processing speed.

What is ImPACT?

ImPACT stands for Immediate Post-Concussion Assessment and Cognitive Testing. It is a computerized test that measures attention span, memory, and verbal and visual problem-solving. It takes about 25 minutes to complete.

ImPACT is used as:

  • A baseline test to measure an individual’s performance baseline.
  • A post-injury test to analyze against the baseline test scores.

ImPACT helps healthcare providers evaluate an individual’s post-injury condition and aids in tracking recovery. It can also play a role in the overall evaluation to determine when a person can safely continue pursuing their chosen sport.

ImPACT is not a diagnostic test. However, it does measure a component of a patient’s recovery from a concussion.

What Is a Baseline Test?

A baseline test is used to establish a benchmark performance score when an athlete or other patient is in their regular, non-concussed state. Ideally, the test should be performed before the sports season begins. The baseline test is valid for up to two years. A baseline test does not evaluate an athlete for a concussion, prevent future concussion, identify past concussions, or determine if they are predisposed to a concussion.

What it does is offer a pre-concussion picture of a person’s brain, which can be compared to an ImPACT test taken soon after the traumatic event.

More About the ImPACT Test

Besides ImPACT being a computerized baseline test, know that it takes approximately 25 minutes to complete. The test can be taken individually or with a team/group. The test results may help gauge when an athlete may resume play and assist in the development of an effective rehabilitation plan. To learn more about the ImPACT concussion test, contact today.

asian girl having a headache

Home »

How Neuro-Optometric Vision Rehabilitation Can Help Post-Concussion

Are you still suffering from post-concussion symptoms? If so, you’re not alone. Up to 90% of people experience some sort of vision problems after experiencing a head injury.

The symptoms that persist following a concussion — which is a mild type of traumatic brain injury — have a name: Post Trauma Vision Syndrome (PTVS). In most cases, the eyes are physically healthy but not communicating properly with the brain. Unfortunately, many doctors don’t recognize the signs of PTVS or know how to treat them.

Our eyes are controlled by the brain, so when someone suffers from any type of injury to the brain, whether it is a stroke, concussion, or car accident, the functioning of the visual system can be significantly impacted and their vision will be negatively affected.

Neuro-optometric vision rehabilitation can help improve your vision and relieve often-disabling post-concussion symptoms

What is Neuro-Optometric Vision Rehabilitation?

Neuro-optometric vision rehabilitation focuses on various visual disorders that occur as a result of brain injuries, concussions, or developmental delays.

Visual problems are often unnoticed during primary treatment of a brain injury, and a regular eye exam will not reveal the extent to which one’s visual system, functioning of the eyes, and visual processing has been affected.

Neuro-optometric rehabilitation therapy is a non-invasive regimen to rehabilitate vision, visual information processing, visual-motor disorders, and integration of vision with other senses. The treatment program usually involves a personalized vision therapy program, therapeutic lenses, or optical prisms. There are also computer-based activities specifically designed to improve the neural functioning following a TBI.

The vision therapy used as part of neuro-optometric rehabilitation is a customized program to redevelop brain-eye communication, allowing you to learn how to regain control of your visual system and improve your quality of life.

A neuro-optometric evaluation goes beyond a regular eye exam. It involves in-depth testing to analyze the communication between the brain and the visual system, and how deficits affect your daily tasks, such as reading, balance and movement, and more.

Successful treatment can be life-changing, so if you or someone you care about is still having trouble after a concussion, make sure their visual function is fully tested.

Common Post-Concussion Symptoms

man having a headache 640Symptoms may vary among individuals post-concussion, but some typical symptoms include:

  • Dizziness
  • Nausea
  • Difficulty with balance, coordination
  • Difficulty reading
  • Difficulty focusing
  • Sensitivity to light
  • Poor depth perception
  • Headaches/migraines
  • Double vision

Unless treated effectively, vision problems associated with brain injuries can be disabling and lead to serious consequences, including additional concussions, especially while playing sports. Common vision problems that may occur following brain injury include:

  • Eye focusing – Your vision may become blurred or the ability to shift focus between objects between near and far distances may be imperiled.
  • Eye teaming – Your eyes may not work together as a team, causing double vision.
  • Eye movements – While reading or trying to follow a moving object you may experience difficulty with eye movements. A common complaint is losing your place while reading.
  • Motion sensitivity – It may be difficult to process motion properly due to a disruption between the visual and balance systems. Symptoms can include motion sickness, disorientation, and even dizziness when scrolling on a computer screen or phone, or when in busy environments such as grocery stores, malls, or stadiums.

Balance is achieved and maintained by a complex set of sensorimotor systems that include the vision (sight), proprioception (touch), and the vestibular system. When any of these systems are not functioning properly you can experience motion sensitivity symptoms.

Vision problems that occur after a concussion can range from subtle to dramatic.

How Can Neuro-Optometric Rehabilitation Help?

Since every injury is unique, treatments will vary by individual.

Below are some types of treatments:

  • Vision Therapy – This is a customized program that improves the communication between your eyes, brain, and body. The training focuses on improving visual skills such as depth perception, hand-eye coordination, eye tracking, focusing, and peripheral vision.
  • Specific Prescription Lenses (Glasses) – These lenses help compensate for the damage done to the neural system along with enhancing visual clarity and comfort. Lens filters provide help with glare and light sensitivity.
  • Prism Lenses – These specialized glasses change the way light enters the eye. Prisms are frequently prescribed as part of vision therapy for binocular vision problems to eliminate double vision. In addition, prisms are often used to treat poor balance, which is a common symptom post-concussion.
  • Patching – Placing a patch on one eye or part of the visual field of one eye helps eliminate double vision. The patch is often placed directly upon the surface of the lens.

Following a concussion or other brain injury, a tailored neuro-optometric rehabilitation program can offer help specific to your particular situation. Contact to learn more about neuro-optometric rehabilitation for Post Trauma Vision Syndrome.

common vision problems img

Home »

Common Vision Problems Associated With a Brain Injury

Some 2.8 million Americans suffer a form of TBI every year, which is close to 1 in every 100 people.

Traumatic Brain Injury (TBI) disrupts the normal functioning of the brain due to a strike or jolt to the head. This can cause vision problems, such as blurred or double vision, and difficulty with eye movements, focus, and tracking. This can result in headaches, dizziness and nausea— especially when someone who has suffered a TBI needs to retain focus on a fixed point or task. Over 10 million TBIs occur annually around the world and around 57 million people have been hospitalized for a TBI at some point in their lives.

Studies show that over 90% of Traumatic Brain Injury patients suffer some form of visual dysfunction, yet vision problems tend to be overlooked during the initial treatment of a brain injury. At times, vision problems don’t manifest until some time has passed— so make sure to pay close attention to any vision changes you may experience following a concussion or head trauma. If you notice any alterations in your vision, contact right away. The eye doctor will determine the causes of the vision change and will provide the appropriate vision therapy treatment.

What Kind of Vision Problems Result From a Brain Injury?

female lookingOften the affected person with a TBI is not aware of their specific vision dysfunction but might complain of one or more of the signs below:

Traumatic Brain Injuries tend to interrupt the communication between the eyes and the brain, which can cause a range of visual dysfunctions. The signs often include:

  • Blurred vision
  • Eyestrain
  • Sensitivity to light
  • Reading difficulties
  • Attention and concentration difficulties

Below is a more detailed list of the common vision problems that can result from brain injury or a medical condition, such as a stroke, tumor, aneurysm, meningitis, cerebral palsy, and other neurological insults.

  • Visual Acuity – Blurry vision, either all the time or can shift in and out of focus.
  • Eye focusing – Inability to quickly change focus from near to far objects.
  • Eye teaming – The eyes not working in tandem, potentially causing double vision.
  • Eye movements – Difficulty following a moving object or losing one’s place while reading.
  • Motion sensitivity – The disruption of the connection between vision integration and balance system which makes it difficult to process motion properly. This can cause vertigo or unease when traveling, scrolling a digital device, or when in busy environments such as grocery stores, social settings, or sporting events.
  • Visual Field Loss – The partial or complete loss of peripheral vision. Visual field loss may cause one to bump into objects, be struck by approaching objects, or experience frequent falls.
  • Visual Memory Loss – Losing the ability to recall or remember visual information stored in long or short-term visual memory. This can have a devastating impact on daily functioning as the individual no longer recalls numbers, words, pictures, or any data viewed in the past. Reading comprehension decreases, and the ability to recognize locations and faces declines. One may not remember where a specific object—such as a car key—was put or how to give directions.
  • Headaches or Eye Pain – Following head trauma, the individual may experience a range of headaches or even a stabbing pain around the eye — at times accompanied by redness, burning, or itching of the eyes
  • Sensitivity to Light – In the aftermath of a brain injury, one can develop sensitivity to light and be unable to tolerate glare. Also known as photophobia, sensitivity to light can be exacerbated by particular light sources, such as bright sunlight and fluorescent lighting. LCD screens, used for computers or smartphone devices, can be particularly intolerable after a concussion.

two friends talkingHow Can Neuro-Optometric Rehabilitation Optometry Help You Recover From a Brain Injury?

People of all ages who develop visual dysfunction due to a neurological trauma or injury can benefit from a vision assessment by a Neuro-Optometric Rehabilitation Optometrist (neuro-optometrist). These eye care professionals are highly trained in the diagnosis, treatment and rehabilitation of neurological conditions that affect the visual system, as well as perceptual and motor disorders. Research studies show that patients having undergone a vision rehabilitation program can vastly improve their quality of life.

An interdisciplinary rehabilitation team is essential for patients with concussions, strokes or other neurological deficits. In addition to optometrists, team members may include nurses, physical therapists, occupational therapists, speech-language pathologists, physical medicine doctors, neurologists, neuropsychologists, audiologists, and ophthalmologists, among others.

The regularly assists patients in retraining their visual system to overcome symptoms and visual conditions caused by brain injury. If you are suffering from any of the above symptoms or conditions, please reach out to us.