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Traumatic Brain Injury Rehabilitation

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Traumatic Brain Injury Rehabilitation

The statistics on TBIs are quite startling. Over 2.8 million Americans suffer a form of traumatic injury each year, which is close to 1 in 100. Traumatic brain injury causes damage to the brain, resulting in headaches, confusion, poor concentration, and vision dysfunctions, among other problems. Fortunately, vision rehabilitation treatment, as part of an integrated team approach, can effectively help in the rehabilitation of patients with traumatic brain injuries.

What Is a Traumatic Brain Injury?

Traumatic brain injury (TBI) occurs when a sudden injury damages your brain. There are two types of TBI: a closed head injury that doesn’t break through the skull (yet may still cause brain damage), and a penetrating head injury, which causes the skull to break.

Approximately 47% of traumatic brain injuries are caused by falls, particularly among young children and those over 65 years of age. Other TBI injuries can result from blunt force trauma (15%), car accidents (14%), and violent physical assaults (9%).

The symptoms experienced following a TBI include headaches, confusion, dizziness, convulsions, poor concentration, memory issues, and personality changes. Because more areas of the brain are used to process vision than any other system, traumatic brain injuries can often result in vision problems.

In order to recover from a TBI, one needs to undergo rehabilitation, which can come in many forms — depending on your specific case and requirements. It may include physical, occupational, and speech therapy, as well as neurological, and psychiatric care. Neuro-optometric rehabilitation, however, is one of the most effective ways to resolve a range of traumatic brain injury vision problems.

Rehabilitation for Traumatic Brain Injuries

kissing wifeDuring its acute stage, moderately to severely injured TBI patients will typically be treated and cared for in the intensive care unit of a hospital. As your needs and abilities change, so will the rehab program. Rehabilitation can take place in various settings, such as inpatient or outpatient rehab hospitals, home-based rehab, day programs, and independent living centers.

What Does Rehabilitation Resemble Following Brain Injury?

Everybody’s needs and functions vary following a brain injury, and each rehab program is designed to match the patient’s unique needs and goals. The program generally includes a case coordinator and several healthcare providers.

The treatments below are offered based on your functions and abilities, such as visual skills, speech ability, mental and behavioral state, language comprehension, among others.

  • Physical therapy
  • Physical medicine
  • Occupational therapy
  • Neuro-optometric rehabilitation
  • Psychiatric and psychological care
  • Speech and language therapy

How Does TBI Affect Vision?

Studies indicate that 90 % of TBI patients experience some form of vision disruption, which is caused by interrupted communication between the eyes and the brain.

Symptoms include:

  • Blurred vision
  • Eyestrain
  • Increased sensitivity to light (photophobia)
  • Reading difficulties
  • Visual periphery defects
  • Color contrast issues
  • Vestibular dysfunction
  • Decreased visual acuity

These visual aberrations may affect professional, educational and other aspects of daily living.

Unfortunately, TBI-related vision problems may often be overlooked during the initial brain injury treatment as visual disruptions may not be present until some time has passed following the accident.

holding handsHow Can an Optometrist Help in the Recovery of a TBI?

Optometrists, who typically work as part of an interdisciplinary team, play a crucial role in treating patients with TBI. Neuro- optometric rehabilitation optometrists (neuro-optometrists) assess and treat TBI-related visual disorders that impact the patient’s rehabilitative progress and quality of life.

At , we see a variety of patients who have had TBI, whether due to a sports injury, motor vehicle accident, or fall, with visual problems range in complexity and severity. By staying on top of the most recent research, can properly tailor a treatment plan to the patient’s unique needs for maximum results.

Two Types of Eye Doctors Specialize in the Detection and Treatment of TBI

Neuro-optometrists

A neuro-optometrist is a Doctor of Optometry (OD) who is highly trained in diagnosing and treating neurological conditions that impact the visual system. The treatment of TBI by a neuro-optometrist is called neuro-optometric rehabilitation (also known as vision rehabilitation).

Neuro-optometric rehabilitation should not be confused with vision therapy, as not all doctors who offer vision therapy are trained in neuro-optometric rehabilitation.

Neuro-ophthalmologist

A neuro-ophthalmologist is a medically trained eye doctor ( MD) who specializes in vision problems relating to the nervous system — such as TBI-related visual acuity loss.

Both neuro-optometrists, such as , and neuro-ophthalmologists can identify TBI-related vision problems. Depending on the type and severity of problems detected, they will develop a treatment plan uniquely designed to eliminate post-TBI vision symptoms and difficulties. Treatments typically include specialized glasses to help with visual processing or in-office and at-home neuro-rehabilitation procedures to reduce symptoms and promote visual recovery.

It is important to note that a single type of vision rehabilitation treatment is often not enough to address all the patient’s needs. That is why an interdisciplinary, integrated team approach can play a vital role in the rehabilitation of patients with traumatic brain injuries.

Neuro-Optometric Rehabilitation for Brain Injuries

Neuro-Optometric Rehabilitation is a personalized treatment regimen for those with visual deficits resulting from traumatic brain injuries, physical disabilities or other neurological issues. The vision complications that develop following a TBI are not related to visual acuity (20/20) but rather to eye teaming, focusing, and tracking. This can result in difficulties in reading and playing sports.

The goal of neuro-optometric rehabilitation is to retrain the visual system and eliminate the visual symptoms that arise from a traumatic brain injury. Fortunately, by using specific eye-training exercises, one can rewire the brain to improve eye function. Just as with other rehabilitation methods, the earlier one starts the eye exercises following a TBI, the better the chance of recovery and sight improvement.

We will use a variety of tools and exercises to train aspects of the visual system in order to improve vision accuracy. The functional skills the doctor will work on will include eye tracking, focusing, and eye teaming, as well as visual discrimination (the ability to discern b’s and d’s), handwriting, and spatial awareness. During the course of the treatment, the patient will be assigned a series of home exercises with specialized equipment. Follow-ups will be regularly scheduled by the optometrist to assess progress.

Should Everyone With a Brain Injury See An Eye Doctor?

If you experience a traumatic brain injury, make sure to see a neuro-optometrist who has special training in TBI-related visual aberrations. This is all the more necessary if you experience any changes in your vision following head trauma.

Children With Traumatic Brain Injury

Though the symptoms of TBI in children resemble those experienced by adults, the functional impact can be very different. Because the brain of a child is in development, a brain injury can result in cognitive impairments. Though not always apparent following the injury, it may manifest itself as the child gets older. Your child may face physical, cognitive, and emotional challenges which can result in struggles for children, their families, schools, and communities.

Therefore, once the child is stabilized following a brain injury, the patient should receive physical therapy, occupational therapy, speech therapy, optometric and neuropsychological testing. Rehabilitation will teach the child how to compensate for impaired or lost functions and will provide strategies on ways to optimize the use of these abilities as they return.

The caring and knowledgeable staff at are always here to help patients experience the best vision care and treatment possible.

Dizziness and Balance Problems

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Dizziness and Balance Problems Related to Vision

Maintaining balance is a complex process that is controlled by three different systems in the body:

  • The vestibular system is mainly located in the inner ear and is responsible for providing the brain with information about head position, spatial orientation, and motion
  • The visual system provides input from your eyes to your brain, and is the dominant system providing cues for maintaining balance and preventing dizziness
  • Proprioceptors in the legs and feet provide the body with a stable platform as well as information on movement and motion

How Can Impaired Vision Cause Dizziness and A Balance Disorder?

If you’ve experienced sea or motion sickness, the common advice is to close your eyes. Doing this removes the impact of the visual system, and can alleviate nausea and dizziness. Any disruption in the eye-brain connection or the visual system can result in dizziness and balance problems.

Dizziness and Vision

When the visual system is negatively impacted, such as after a concussion, stroke or other traumatic brain injuries (TBI), dizziness can occur.

The most common causes of vision-related dizziness include:

  • TBI
  • Eyestrain
  • Incorrect eyeglass or contact lens prescriptions
  • Binocular vision disorder (eye misalignment)

dizziness balance disorders

In many cases, dizziness is caused by binocular vision problems. When the eyes are misaligned, they receive conflicting signals from the brain and can deviate from their correct position. The eyes therefore strain to put the images back together for a unified and clear view of their surroundings. The extra stress on the eye muscles can cause them to quiver, which can lead to light-headedness or dizziness.

Eye misalignment that causes dizziness can be so slight that it is often overlooked in routine eye exams. For this reason, it is vital for anyone who is suffering from dizziness or balance problems to have a complete functional visual assessment with to rule out visual dysfunction as a cause of the symptoms.

Balance Problems and Vision

People suffering from a balance disorder can be in a still position but feel as if they’re moving. Additionally, they may find it difficult to walk straight, especially after being in a sitting or reclining position and suddenly standing up.

Vision problems can make it challenging to maintain proper balance. When someone has troubled vision and the eye muscles work harder to compensate for the decreased visual clarity, eyestrain, headaches, and balance disorders can occur.

The most common causes of vision-related balance problems include:

  • Blurry or double vision
  • Binocular Vision Dysfunction (eye teaming)
  • Concussion
  • Hemianopsia (blindness in one half of the visual field)
  • Nystagmus (involuntary and repetitive eye movements)
  • Spatial Disorientation
  • Vertigo
  • Visual Midline Shift Syndrome

Treatment for Vision-Related Dizziness and Balance Problems

Dizziness and balance problems often go hand in hand, and if a visual problem is at the root, a neuro-optometric rehabilitation therapist can offer help.

What Is Neuro-Optometric Rehabilitation Therapy?

At , we provide neuro-optometric rehabilitation, which is a personalized program of weekly therapy sessions to improve, refine, or develop new or lost visual skills. This specialized treatment involves various techniques and exercises that improve your visual perception and processing, thereby strengthening the eye-brain connection.

Before the neuro-optometric rehabilitation program begins, you’ll undergo a comprehensive eye exam to assess visual skills and determine whether visual dysfunction is present. Aside from visual function and overall eye health, will also check for eye coordination, blurry or double vision, and any other ocular condition that could be causing symptoms.

Once the cause of the condition is identified, we will recommend a customized treatment plan and treat it. In many cases, vestibular therapy will also be recommended to complement the visual treatment. Vestibular therapy is a special type of physical therapy aimed at restoring correct balance to provide relief for symptoms of dizziness.

When Should You Seek Treatment?

It’s important to be evaluated by a neuro-optometrist as early as possible following even a minor TBI. The sooner treatment begins, the greater the likelihood of success. That said, there is still hope for patients who suffer from symptoms caused by a head injury that occurred months or even years prior; we can still assess your situation and develop a course of treatment to help you recover now.

How Long Does Treatment Take?

No two patients are alike — if you’ve seen one head injury, you’ve seen one head injury. Each person experiences a unique degree of dizziness, balance issues, or vision problems. Some patients may require just a few weeks of treatment, while others may require something more long-term. The good news is that the improvements achieved by neuro-optometric rehabilitation therapy are generally long-lasting.

How We Can Help

If you or a loved one is experiencing any symptoms of dizziness or feeling off-balance, contact for a consultation. Even if you’ve been told that your symptoms are stress-related, seasonal, or will fade on their own, having a functional visual evaluation can help rule out vision as being the root cause or contributing factor to your symptoms.

It’s also important to note that not every optometrist is trained in this specialized field. Only a neuro-optometrist should assess and treat a post-TBI patient with neuro-optometric rehabilitation therapy. We has the expertise and latest technology to provide you with the top-level care you deserve.