Each year an estimated 1.5 million Americans sustain a traumatic brain injury (TBI). According to the Neuro Optometric Rehabilitation Association, 90% of traumatic brain injuries result in vision problems.

Standard glasses are generally not an effective intervention for correcting visual deficiencies caused by traumatic brain injury, acute brain injury, and other neurological disorders and complications. In cases where glasses are not effective, vision therapy or neuro optometric rehabilitation may be necessary to improve daily living skills and learn and refine visual-motor skills.

What is vision therapy?

Vision therapy is similar to physical therapy, but instead of treating muscles in the body, it strengthens the eyes and ocular system. In addition to improving our patients' visual skills, it has also improved their emotional well-being. Having the ability to regain their independence and participate in daily activities increases their self-confidence. Both children and adults can benefit from vision therapy.

What kinds of activities are done in vision therapy and how do they help someone who has experienced a traumatic brain injury?

When working with a TBI patient in a neuro optometric rehabilitation program that includes vision therapy, our eye doctor and therapists will focus on the primary diagnosis that the patient is struggling with. We utilize a whole toolbox that includes therapy, syntonics, and prism lenses to improve the visual function and reduce symptoms of the patient.

What is a vectogram used for in a vision therapy  program for TBI?

One of the things we will work on in vision therapy is eye teaming. Among the most common procedures we perform is vectograms, and this involves the use of a polarized target that is being moved towards and away from you while you wear polarized glasses. Vectograms help you learn to use your eyes to converge (look close) or diverge (look far).

How is accommodative dysfunction treated in a vision therapy program for TBI?

Another common diagnosis we see is difficulty with accommodative or focusing systems. We commonly use plus or minus lenses to treat it. Lenses such as these will either magnify or minimize images. In these cases, we move you back and forth in order to stimulate or relax the focusing muscles.

How does a peg board help in treating ocular motility disorders?

To treat ocular motility disorder, we will ask you to perform a peg board. At first, the board may be stationary, and you will have to insert the pegs without hitting the board. As you become more comfortable, we may turn on the peg board to where it is rotating while you perform the procedure.

How is peripheral vision improved in vision therapy?

Additionally, we work on peripheral integration, and in this case, we may use techniques such as the four chart fixation. So you are reading the rows of letters on the four charts and as you are going along the therapist may call out a different color and you have to see that in your periphery and tap that color. As an example, you might be reading the bottom row of a chart when the therapist calls out red, so you tap the red circle and keep reading.