A recent study noted that people with concussions or other traumatic brain injury often have a number of eye movement deficits. Sometimes the term oculomotor is used to refer to eye movement. The study noted that over 90% of patients with brain injuries such as concussion and other injuries were found to have one or more oculomotor dysfunctions.
The vision rehabilitation therapy that we provide in our office, sometimes called oculomotor rehabilitation or oculomotor training, is effective in providing significant improvement in eye motor disorders that result from traumatic brain injuries ranging from concussions, severe head injuries and strokes.
Convergence and divergence
A study entitled "Effect of oculomotor rehabilitation on vergence responsivity in mild
traumatic brain injury", published in 2013 in the Journal of Rehabilitation Research & Development examined a group of patients before and after they received oculomotor training and placebo therapy to determine whether there was improvement in their visual convergence and divergence ability. Convergence refers to the way the eyes move inward or converge when doing near work. Divergence refers to the ability of the eyes to move outward or diverge when focusing on objects that are moving away from the body.
The researchers found that convergence and divergence abilities improved significantly following oculomotor training, as did depth perception and visual attention. No improvement resulted from placebo therapy, suggesting that the the rehabilitation therapy was effective and that no improvement is expected in the absence of therapy. The authors concluded that there was "overall improvement in nearly all of the critical, abnormal measures of vergence was observed both objectively and clinically. Improved vergence motor control was attributed to residual neural visual system plasticity and oculomotor learning effects in these individuals."
Disorder of accommodation
Accommodation refers to the ability of the eyes, through a complex neurological process, to change optical power to maintain a clear image or focus on an object as its distance from the eyes varies.
A 2014 study entitled "Effect of oculomotor rehabilitation on accommodative responsivity in mild traumatic brain injury" and also published in the Journal of Rehabilitation Research & Development looked at the effect of vision therapy rehabilitation for a group accomodation disorders.
The researchers looked at 12 patients with concussions and other mild traumatic brain injury who had vision related symptoms and gave them a program of rehabilitative oculomotor training of the kind we provide at our clinic (lasting six weeks with two three hour sessions per week) as well as placebo therapy. The researchers found that the rehabilitation program produced significant improvement in the patients' accommodation abilities. No improvement was found following placebo therapy.
The authors conclude that "[t]hese results provide evidence for a significant positive effect of the accommodatively based OMT on accommodative responsivity. Such improvement is suggestive of oculomotor learning, demonstrating considerable residual brain-visual system plasticity in the adult compromised brain."
Similar results were obtained in a 2002
study by Kapoor and Ciuffreda in the journal,
Current Treatment Options in Neurology, where the authors stated that binocular vision problems such as problems of accommodation, vergence, version and other are amenable to optometric vision therapy, either performed in isolation or in conjunction with lens prescriptions that treat double vision, light sensitivity and visual-spatial hemispheric inattention.
Visual attention and visual search
A study published in the June 2014 issue of the journal Brain Injury entitled "Effect of Oculomotor Vision Rehabilitation on the Visual-Evoked Potential and Visual Attention in Mild Traumatic Brain Injury" found that oculomotor vision rehabilitation training was responsible for significant improvements in a number of vision function parameters in patients who had suffered a mild traumatic brain injury such as a concussion. Specifically, the study found significant improvement in the amplitude and latency of the visually evoked potential as well as improvements in Visual Search and Attention Test scores.
90% of patients improved with vision therapy
In a 2008
study by Ciuffreda et al. published in the journal Optometry, 90% of patients with traumatic brain injury who were treated with vision therapy had significant improvement in their eye movement disorders.