VISION THERAPY AND ACQUIRED BRAIN INJURY

The eye is amazing. Did you know more than 1.9 million fibers come from the eye into the brain? Each of those fibers creates its own pathway to the brain and has its own distinct function. So when someone has a stroke or other acquired brain injury (ABI), vision is often affected.  ABIs include concussions suffered in severe sports-related hits or a car accident, as well as cerebral or vascular strokes. An ABI can affect both neurological pathways in the eye, the focal or parvocellular pathway, which is....

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SYNTONICS: CREATING BALANCE FOR THE EYES

Syntonics, or optometric phototherapy, is a form of light therapy used to treat a variety of vision problems. It is available at Family Eyecare Associates to help patients with a variety of vision problems, such as strabismus (eye turns), amblyopia (lazy eye), focusing and convergence problems and learning disorders. It has also been shown to be very effective for people who suffer from migraines.

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WHAT IS BEHAVIORAL OPTOMETRY?

Behavioral optometry starts with the concept that vision is learned. When we’re born, we don’t know how to use our arms, legs and hands. We also don’t know how to use our eyes. We have to learn how to integrate them with the rest of our body. The brain must process what the eyes are seeing, and then it has to integrate that information with the other senses. From a behav- ioral standpoint, seeing requires a more holistic approach, getting all the senses to work together.

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BRAIN INJURY CAN AFFECT VISION

A concussion, also known as a traumatic brain injury (TBI) or an acquired brain injury, can adversely affect vision. Unfortunately, possible visual problems are often overlooked during the initial treatment of a concussion. Perhaps a coach or doctor will move a finger in front of the patient’s eyes to see how they track movement, but this cursory examination does not get to the deeper repercussions of the injury.


What happens with a TBI is that the brain gets shaken, incurring multifunctional problems and often disrupting neural pathways, including the two visual pathways (focal and ambient). This irregular movement in the brain can affect motor skills, balance and general orientation.


Some of the symptoms of visual problems that can result from a TBI include headache, blurred vision, increased sensitivity to light, reading difficulties and difficulty concentrating. Memory and attention are often impacted as well. The patient may also have problems with eye tracking (the ability to move the eye smoothly across a printed page or while following a moving object); focusing (looking quickly from far to near and back without any blurring); eye teaming (using the eyes together as a team – smoothly, equally and accurately); and depth perception (judging relative distances of objects – how far or near they are). These vision problems are hidden disabilities a physician should look for following any sort of acquired brain injury. If these symptoms are ignored and

rehabilitation is delayed, the long-term effects of the TBI can result in an ongoing disruption in the receiving and processing of information, since the eyes and the brain are interdependent.


Visual field loss or reduction is another possible result of a TBI. The visual field is the complete central and peripheral range. Many patients who have had a major brain trauma usually have hemianopia, which is decreased vision or blindness in half the visual field. Basically, you are unable to see anything to the right or left. It is always best to seek treatment as soon as possible. However, even if there is permanent visual field loss, vision therapy can make you more functional with the field that remains.


These problems can be successfully decreased or eliminated with various vision therapy treatments, such as neuro-optometric rehabilitation therapy, low-vision aides, specially tinted lenses that reduce light sensitivity and prism lenses. Through vision therapy and the proper use of lenses, a behavioral optometrist specifically trained to work with TBI patients can help improve the flow and processing of information between the eyes and the brain, thus increasing vision

efficiency. The damaged pathways can be retrained and restored. The patient receives positive feedback just as he would with physical or occupational therapy.


Any time you have a head incident, be sure to have yourself thoroughly checked, including your vision. It is always better to be safe than sorry. For more information about neuro-optometric rehabilitation therapy, visit the Web page of the Neuro-Optometric Rehabilitation Association at www.nora.cc.

DR. RICK GRAEBE

Dr. Graebe received both his B.S degree in Visual Science and Doctorate of Optometry from Indiana University. He is a Behavioral Optometrist and learning expert. He has been in private practice here in the Bluegrass area for the past 32 years.

more articles by dr rick graebe