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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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 related to central vision, and the ambient or magnocellular pathway, which are those things that are in the background that you don’t focus on. The ambient pathway also encompasses peripheral vision. Simply put, the ambient vision system provides information about where you are in space and where you are looking and contributes to balance, movement, coordination and posture. In addition, it controls how well the eyes point and track. The focal system, on the other hand, provides information about what you are looking at.


With an ABI, one of the first things to go is eye-tracking ability.  This may cause the patient to have double vision or perhaps perceive printed words on a page as “swimmy” because the eyes aren’t aligned property. The patient may have trouble with spatial awareness, judging distances, catching balls or other activities that require the eyes to work together. Other symptoms of an ABI include blurred vision; light sensitivity;

difficulty concentrating, reading and comprehending; headache; and visual field loss. You may also have trouble shifting your gaze quickly from one point to another after an ABI.


Stroke is a change in or lack of blood flow to some areas of the brain. It can also cause bleeding on the brain. Patients who have had a stroke or traumatic brain injury may lose half of their right or left side vision. This type of side vision loss is called hemianopsia. Patients who just have a hemianopsia are aware of the side vision loss and often can be easily taught to scan their eyes in the direction of the hemianopsia so they can compensate for the field loss. This helps them not miss things that are on the side of the hemianopsia.


Fortunately, the brain is quite adept at training itself how to recreate and reconnect pathways or even create new ones. No one is born knowing how to use their arms and legs, much less their eyes. Through interaction with the world, we learn to walk and talk and to point and use our eyes. Once you understand space and where things are, the brain creates neurons that will fire together and you will point, track, focus and otherwise engage your eyes subconsciously. Vision therapy or vision rehabilitation can help when ABI interferes with these vital abilities. You may be fitted with corrective lenses such as yoked prism lenses or receive light therapy or syntonic optometry. Vision therapy, as with all other types of therapy, is very personalized.


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