What to Expect in Terms of Glasses
Lenses, prism, tints and other refractive aids
Optometric Vision Rehabilitation Therapy (OVRT) often incorporates ophthalmic lenses, contact lenses, prisms, yoked prisms, coloured filters and/or sectoral binasal occlusion to help improve visual function. Lenses are generally prescribed specifically to improve eye teaming and visual-vestibular integration; and reduce eyestrain, visual motion hypersensitivity and disequilibria. Depending on the patient’s individual responses, these are sometimes prescribed; however, often they are only used therapeutically in-office.
Frequently, more than one pair of glasses may be prescribed as different lenses serve different purposes and it is often not possible for one pair of glasses to do everything well. For example, separate pairs of single vision distance and reading lenses are often initially prescribed, as multifocal lenses (e.g. progressive lenses) tend to provoke symptoms of visual motion hypersensitivity and disequilibria. Even though tinted lenses may be prescribed for indoor use, darker prescription sunglasses are often beneficial for brighter, sunnier days. It is not uncommon at Vision & OpticNeuro Care for refractive prescriptions to be finalized and requested after OVRT has been initiated.
Use of lenses
Prescribing lenses to see clearly (i.e. to achieve 20/20) is standard optometric and ophthalmic practice. Prescribing lenses to maximize visual function often requires more investigation time and more in-depth testing of visual skills. Determining the lens power that minimizes visual stress and optimizes visual function may not necessarily be the lens that provides maximum visual clarity. Prescribing the sharpest clarity lens in patients who have a visual-vestibular mismatch can sometimes exacerbate symptoms.
Use of prisms
Unlike standard ophthalmic lenses which improve visual clarity by correcting refractive conditions such as nearsightedness, farsightedness, and astigmatism; prism lenses are wedge-shaped lenses that serve purposes other than improving visual acuity. Prisms lenses are a standard tool of optometric and ophthalmologic practice and have been used for hundreds of years to improve eye-coordination, reduce double vision, improve depth perception, and relieve eyestrain. More recently, prisms are being used to influence balance, gait, posture, and visual-vestibular integration to treat patients with acquired brain injury. Yoked prisms (i.e. prisms prescribed in pairs to affect both eyes simultaneously) are often used for this purpose. Dr. Loopeker utilizes prisms in multiple different ways as clinically appropriate.
Use of tints
Light sensitivity (photosensitivity) can be a significant problem for many patients when standard sunglasses don’t work effectively. Dr. Loopeker’s OpticNeuro Vision Exam includes an assessment to determine what wavelength-specific filter (i.e. tints) provides the greatest symptom relief. Multiple ophthalmic tints, such as various FL-41’s and anti-migraine tints, are used to determine the most symptom-reducing effect. Tinted contact lenses provide an alternative option for some patients.
Use of contact lenses
Contact lens correction of refractive error often offers several benefits over spectacle correction in patients suffering from acquired brain injury. It may be beneficial for Dr. Loopeker to prescribe multiple layers of refractive correction using full-time contact lens wear as a base to manage pre-existing myopia, hyperopia and astigmatism. Then prescribe prism glasses to be worn over the contact lens to therapeutically manage visual-vestibular mismatch and/or binocular instability at various viewing distances.
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