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Accurate vision is an important part of performing well at work, school, and in other everyday activities. In certain cases, however, medical conditions or injury may lead to visual impairment. For individuals with functional limitations resulting from visual impairment, visual rehabilitation can improve or restore everyday abilities. The most effective model for visual rehabilitation is one in which a patient receives input from his or her optometrist, medical doctor, psychologist, neurologist, and other allied health professionals to create an individualized visual rehabilitation plan.

Visual Rehabilitation Procedures
 

Visual rehabilitation involves constructing an individualized treatment plan to address each person’s unique issues. In some cases, this may involve occupational therapy to make a person’s environment easier to navigate. For many patients, however, vision therapy offered by an optometrist is an excellent way to improve or fully restore visual functioning.

Analogous to physical therapy for the vision system, vision therapy involves special exercises designed to retrain eye-brain circuits to perform more normally.  Patients may be asked to view objects through special prism lenses, focus on an object as it moves, coordinate eye-body movements, or perform computerized tasks. Over time, these exercises improve visual deficits and reduce functional impairment.

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 Post-Concussive Vision Syndrome

  Category: Visual Rehabilitation

 

More than 300,000 sports-related concussions occur each year, according to research. Many more concussions result from motor vehicle accidents, falls, and other non-sports-related incidents. In addition to causing cognitive difficulties, concussions may result in a cluster of problems called post-concussive

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 Special Needs

  Category: Visual Rehabilitation

 

The cognitive differences of special needs children and adults are well-documented, but vision issues often receive less attention. People with special needs have the same range of vision issues as their neurotypical counterparts; however, these vision problems occur at a much higher rate in special

 

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 Traumatic Injury

  Category: Visual Rehabilitation

 

Accurate vision involves much more than good eye health. The brain integrates signals from the eyes with information from the motor, balance, and auditory systems to create an accurate view of the world. Following traumatic injury, one or more components of this complex system may be damaged. Receiving

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Post-Concussive Vision Syndrome

Created in Visual Rehabilitation

More than 300,000 sports-related concussions occur each year, according to research. Many more concussions result from motor vehicle accidents, falls, and other non-sports related incidents. In addition to causing cognitive difficulties, concussions may result in a cluster of problems called post-concussive vision syndrome. If you have recently experienced a concussion, consult an optometrist for a full vision exam to identify possible problems.

Most Common Symptoms of Post-Concussive Vision Syndrome

A concussion is simply an injury to the brain following some type of blow to the head. In serious cases, this may cause shearing of nerves in the brain or traumatic damage to certain brain areas. If parts of the visual system are impacted, some of the following symptoms may result:

  • Double vision. Seeing two versions of the same object is a sign of double vision, which may result from damage to the eyes, eye muscles, or portions of the brain.

  • Blurred vision.

  • Light sensitivity or sensitivity to glare.

  • Difficulty reading, including words “swimming” on the page

  • Problems attending to visual information

  • Eye strain, even following relatively minor visual tasks

  • Headaches after reading or performing other visual tasks

  • Problems focusing on objects (also called accommodative dysfunction)

  • Difficulty following moving objects

  • Impairment in quickly shifting gaze from one point to another

  • Loss of a portion of the visual field.

Treatment of Post-Concussive Vision Syndrome

Your optometrist will recommend an individualized treatment program to address your symptoms of post-concussive vision syndrome. This may include corrective lenses to address problems with visual acuity or focusing.

Additionally, your optometrist may recommend vision therapy. Vision therapy is not simply designed to exercise your eye muscles; rather, it involves a series of special exercises supervised by a doctor. These exercises can retrain your eyes to respond differently to visual stimuli. For example, you may practice focusing, viewing objects through special prisms or lenses, using special techniques to track an object with your eyes, or responding to visual stimuli with a particular movement to improve eye-body coordination.

In most cases, vision therapy involves visiting the doctor’s office for 30 to 60 minutes, once or twice per week. Often the eye doctor will recommend that you practice certain exercises at home. This homework gives your eyes additional practice, retraining your eyes and brain to behave as they did before your concussion.

 
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Special Needs

Created in Visual Rehabilitation

The cognitive differences of special needs children and adults are well-documented, but vision issues often receive less attention. People with special needs have the same range of vision issues as their neurotypical counterparts; however, these vision problems occur at a much higher rate in special needs populations. Involving optometrists in your loved one’s care team allows their vision issues to be addressed alongside cognitive, behavioral, and other issues.

What Special Needs Populations May Have Additional Vision Issues?

Although many people with special needs have perfect eyesight, it is important to receive a comprehensive eye exam to rule out potential problems that may contribute to learning or behavioral difficulties. The following populations are at increased risk of vision problems requiring special treatment:

  • Down Syndrome. More than half of kids and adults with Down Syndrome have some form of eye problems, including tear duct abnormalities, early age cataracts, accommodative dysfunction, or strabismus (eye misalignment).

  • Autism spectrum disorder. A diagnosis ranging from Asperger’s syndrome to severe neurobehavioral problems, children with autism spectrum disorder display a range of cognitive and behavioral difficulties. Behaviors such as poor eye contact, sensitivity to light, atypical reactions to visual stimuli, or looking through or beyond objects are common. Some of these behaviors may be due to direct vision problems, such as problems with focusing or relaying visual messages to the brain.

  • Fragile X. Individuals with Fragile X, a genetic disorder that more often impacts boys, may have difficulty with hand-eye coordination, spatial awareness, and visual sequencing. These vision issues often lead to learning difficulties.

  • Premature birth. Children born prematurely may have difficulty with vision or visual processing. A thorough eye exam can diagnose subtle vision problems that impact typical development

Vision Therapy for Special Needs

After careful diagnosis of eye disorders, your optometrist can recommend a range of treatment options to correct vision problems. In some cases, simply using corrective lenses can improve visual acuity and attention. For other individuals, vision therapy may be needed.

Vision therapy retrains the eyes and brain to react differently to visual stimuli. For example, someone with hand-eye coordination difficulty might practice reaching, grasping, and following objects visually. Vision therapy typically includes in-office sessions to master key skills, followed by at-home practice exercises. Successful vision therapy may significantly improve visual attention and positively impact overall learning ability in those with special needs.

 
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Traumatic Injury

Created in Visual Rehabilitation

 

Accurate vision involves much more than good eye health. The brain integrates signals from the eyes with information from the motor, balance, and auditory systems to create an accurate view of the world. Following traumatic injury, one or more components of this complex system may be damaged. Receiving a thorough vision assessment following a traumatic injury can speed treatment of visual deficits as well as overall recovery.

Anatomy of the Visual System

Vision begins when light enters each eye, stimulating cells on the back of the eyeball. These signals are summed and sent through the optic nerve extending from the back of each eye. The optic nerves cross over to the opposite side of the brain before relaying visual information to the occipital lobe, found in the very back of the head. Here, visual information undergoes more complex processing to identify objects, see movement, and visualize color. Damage to any part of this pathway -- from direct trauma to the eyes themselves to head injury -- may disrupt accurate visual processing.

Potential Vision Problems Following Traumatic Injury

Depending on the part of the head affected, a variety of vision problems may arise following a traumatic injury. Some common issues include:

  • Visual acuity. Some individuals may experience nearsightedness (poor distance vision), farsightedness (poor close vision), or other issues with visual acuity following injury. These are most often treated using corrective lenses.

  • Loss of visual field. Sometimes, a person may lose the ability to see out of an entire quadrant or half of the visual field.

  • Double vision (diplopia). Double vision often occurs after an injury, affecting almost all everyday activities.

  • Visual alignment. When the eyes turn inward, outward, up, or down, you may have difficulty fixating on an object, smoothly tracking moving objects, or scanning.

  • Visual-motor integration. Loss of eye-hand or eye-body coordination often leads to difficulty performing everyday tasks.

  • Visual-auditory integration. The visual and auditory systems communicate constantly. Injuring this system impairs the ability to associate what is seen with what is being heard at the same time.

Treatment Options

While certain vision problems can be easily treated with corrective lenses, others may require vision therapy. A vision therapist will work with you to practice skills to improve the coordination of eye signals with behavioral responses. Although some visual skills take months or even years to fully recover, practicing daily improves the likelihood of a full recovery.