What to Expect in Terms of Treatment

Vision Therapy

Vision Therapy is a clinically recognized incremental biofeedback therapy program that develops, rehabilitates or enhances the functioning of the visual system and improves the coordination and integration of the visual system with the body’s other motor, sensory, and cognitive systems.

Vision Therapy is taught in every optometry school with ample published research supporting its use and benefit, including within the area of vision rehabilitation. Numerous internationally-recognized post-graduate optometric residency programs and associations exist to support, educate and certify advanced clinical competency in vision rehabilitation.

Optometric Vision Rehabilitation Therapy (OVRT)

Optometric Vision Rehabilitation (OVRT) is a term used to describe a specific type of vision therapy offered by optometrists prescribed to patients with acquired brain injury. Optometrists with post-graduate training in this area are sometimes referred to as neuro-optometrists by the public to help differentiate them from their colleagues, although the permissible use of “neuro-optometrist” by the practicing optometrist is governed by local provincial/state laws. Optometrists with post-graduate training in optometric vision rehabilitation therapy often work in rehabilitation hospitals and are an invaluable member of an interdisciplinary brain injury rehabilitation medical team.

Unlike other practitioners who may do vision exercises, optometrists possess the unique training and skill to use lenses to modify the electrical signals entering the brain through the eye, potentially altering the patient’s perception of space, influencing their relationship to gravity, and facilitating modification of posture and gait. Interpretation of external (egocentric) and internal (somatic) spatial localization is heavily influenced by the visual process. Using special lenses, prisms and filters, optometrists are able modify the amount and wavelength of light that stimulates specific areas of the retina and very specific corresponding areas of the brain.

Lenses, prisms and filters can be used therapeutically to modify brain activity to modify visual-vestibular integration and alter posture and gait. Facilitating and resynchronizing a potential visual-vestibular sensory mismatch, has been demonstrated clinically to reduce visual motion hypersensitivity and disequilibria; improve balance, stability and sense of groundedness; improve ambulation, turning, ability to bend up and down, and navigate stairs; and improve eye-hand coordination and ability to accurately judge space and time. Apparent re-establishment of accurately and reliably understanding where their body is in relationship to their physical environment has also been clinically demonstrated to improve auditory and spatial processing, improve overall cognitive processing, and reduce anxiety as the patient feels more grounded and connected to their external environment and physical body. Establishing a stronger connection between the visual and vestibular system helps create a better neurological foundation for other additional brain and physical rehabilitation therapies to occur, and helps to promote neuroplasiticity.

OVRT at Vision & OpticNeuro Care

We take great pride in being able to offer a customizable treatment protocols based upon the individual needs of our patients. The purpose and goals of each patient’s Optometric Vision Rehabilitation Therapy program is unique; however, frequent goals of OVRT include:

• Improve eye movement (pursuits, saccadic and fixation) control (e.g. accuracy)
• Improve eye focusing (accommodation) control (e.g. amplitude, flexibility)
• Improve eye teaming (binocularity) ability (e.g. eye movement coordination, eye alignment, sensory fusion, convergence)
• Improve co-ordination and integration between the accommodative (focusing) and vergence (alignment) ocular systems
• Improve spatial awareness (e.g. stereopsis, depth perception, central-peripheral visual awareness)
• Improve visual-vestibular integration and sense of balance, and reduce disequilibria
• Re-integration of vision with other systems such as: visual-auditory integration, visual-cervical integration, eye-hand coordination.

Our Optometric Vision Rehabilitation Therapy (OVRT) program for our concussion and neurological rehabilitative patients are based upon three common pillars:

1. Visual-vestibular integration therapy
2. Visual therapy, incorporating visual skills training
3. Therapeutic use of lenses, prisms and optical filters

Most patients require all three therapeutic components and every patient’s OVRT plan is customized to meet their individual needs. As every brain injury is different, the absolute and relative number of OVRT appointments are multi-factorial and often difficult to predict accurately, particularly at the conclusion of the assessment.  The extent of overall recovery possible with OVRT is often difficult to accurately predict.  Recovery is patient-specific and we do our best to work with each individual to support their personal outcome goals.