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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 Fox Vision Development Center, 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, our optometrists 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 our optometrists, 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 Fox Vision Development Center are always here to help patients experience the best vision care and treatment possible.

Our practice serves patients from Latham, Albany, Glens Falls, and Troy, New York and surrounding communities.

Request A Functional Visual Exam
Find Out How We Can Help You! 518-374-8001

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Sensitivity to Light Following a Brain Injury

If you find yourself to be more sensitive to light following a concussion, it could be related to your head injury. That’s especially true if you’ve been experiencing other post-concussion symptoms like eye strain, blurry vision and double vision.

Fortunately, neuro-optometric rehabilitation can effectively alleviate concussion-related light sensitivity (photophobia) and other TBI symptoms.

Symptoms of Light Sensitivity After a Concussion

While light sensitivity is a common problem after a head injury, sometimes it can be hard to recognize, as it often overlaps with other symptoms related to brain injury.

The most common symptoms of post-concussion light sensitivity include:

  • Inability to tolerate bright light
  • Discomfort from interior lighting or computer screens
  • Eye pain
  • Eyestrain
  • Eye fatigue
  • Headaches

Additional post-concussion symptoms may include:

  • Vertigo or dizziness
  • Cognitive fatigue
  • Difficulty multitasking

While these symptoms are not necessarily caused directly by light sensitivity, they often go hand-in-hand. In addition, your brain may be using extra energy to process bright light after a brain injury, limiting the energy it has left for other activities.

Causes of Light Sensitivity After Head Injury

Following a TBI, photophobia tends to occur as a result of damage to a specific part of the brain called the thalamus.

The thalamus filters incoming visual information and sends neural signals to different parts of the brain. After a brain injury, the blood vessels that deliver oxygen to the thalamus can become damaged and withhold vital oxygen and nutrients to this part of the brain.

If the thalamus is not filtering the incoming light correctly, your brain may become overwhelmed with too much visual information. This is why many concussion patients prefer dark rooms that present less visual stimulation.

Note that light sensitivity can also develop as a result of damage to any of the following:

Autonomic Nervous System (ANS)

The ANS governs most of your body’s autonomic processes, such as blood pressure, breathing, heart rate, pupil dilation and more. If an injury disrupts your ANS, your pupils may dilate more than usual, allowing too much light to enter the eye, leading to light sensitivity.

Superior Colliculus

The superior colliculus is the part of the brain that keeps you oriented in space and has some control over your eye muscles. It has the potential to make a person’s vision more sensitive if it malfunctions.

Vestibular System

The brain uses three systems: the inner ear vestibular system, the sense of touch and the sense of sight. These help people determine and understand where they are relative to the things around them.

If your vestibular system is not operating correctly, your brain receives conflicting information from the vestibular and visual systems. To compensate, your brain may increase its sensitivity to the visual system, which can result in light sensitivity.

Following a brain injury, a person will usually have a combination of these problems. Fortunately, they can be treated.

Neuro-Optometric Rehabilitation Can Help

Neuro-optometric rehabilitation is a customized treatment program for patients who have visual deficits due to physical disabilities and TBIs. Neuro-optometric rehab aims to strengthen any reduced visual skills so that the patient can continue engaging in daily activities, like reading and driving, and enjoy a higher quality of life.

A neuro-optometric rehabilitation optometrist evaluates many functions of the visual system, such as how the eyes work together as a team. Treatment options may include using filters and prisms, and customized visual exercises to strengthen the eye-brain connection. To determine if you can benefit from neuro-optometric rehabilitation, schedule a functional vision evaluation with Fox Vision Development Center today.

Our practice serves patients from Latham, Albany, Glens Falls, and Troy, New York and surrounding communities.
Request A Functional Visual Exam
Find Out How We Can Help You! 518-374-8001

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ImPACT Concussion Testing

A concussion is the most common type of traumatic brain injury (TBI). Every concussion is different; symptoms and recovery depend on the nature of the injury, the patient’s age, and overall health, among other factors.

One of the best ways to evaluate a person’s brain health is by comparing post-concussion brain function with pre-concussion brain function. ImPACT concussion testing provides before and after comparisons that measure your memory, reaction time, and processing speed.

What is ImPACT?

ImPACT stands for Immediate Post-Concussion Assessment and Cognitive Testing. It is a computerized test that measures attention span, memory, and verbal and visual problem-solving. It takes about 25 minutes to complete.

ImPACT is used as:

  • A baseline test to measure an individual’s performance baseline.
  • A post-injury test to analyze against the baseline test scores.

ImPACT helps healthcare providers evaluate an individual’s post-injury condition and aids in tracking recovery. It can also play a role in the overall evaluation to determine when a person can safely continue pursuing their chosen sport.

ImPACT is not a diagnostic test. However, it does measure a component of a patient’s recovery from a concussion.

What Is a Baseline Test?

A baseline test is used to establish a benchmark performance score when an athlete or other patient is in their regular, non-concussed state. Ideally, the test should be performed before the sports season begins. The baseline test is valid for up to two years. A baseline test does not evaluate an athlete for a concussion, prevent future concussion, identify past concussions, or determine if they are predisposed to a concussion.

What it does is offer a pre-concussion picture of a person’s brain, which can be compared to an ImPACT test taken soon after the traumatic event.

More About the ImPACT Test

Besides ImPACT being a computerized baseline test, know that it takes approximately 25 minutes to complete. The test can be taken individually or with a team/group. The test results may help gauge when an athlete may resume play and assist in the development of an effective rehabilitation plan. To learn more about the ImPACT concussion test, contact Fox Vision Development Center today.

Our practice serves patients from Latham, Albany, Glens Falls, and Troy, New York and surrounding communities.
Request A Functional Visual Exam

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Common Vision Problems Associated With a Brain Injury

Some 2.8 million Americans suffer a form of TBI every year, which is close to 1 in every 100 people.

Traumatic Brain Injury (TBI) disrupts the normal functioning of the brain due to a strike or jolt to the head. This can cause vision problems, such as blurred or double vision, and difficulty with eye movements, focus, and tracking. This can result in headaches, dizziness and nausea— especially when someone who has suffered a TBI needs to retain focus on a fixed point or task. Over 10 million TBIs occur annually around the world and around 57 million people have been hospitalized for a TBI at some point in their lives.

Studies show that over 90% of Traumatic Brain Injury patients suffer some form of visual dysfunction, yet vision problems tend to be overlooked during the initial treatment of a brain injury. At times, vision problems don’t manifest until some time has passed— so make sure to pay close attention to any vision changes you may experience following a concussion or head trauma. If you notice any alterations in your vision, contact our optometrists right away. The eye doctor will determine the causes of the vision change and will provide the appropriate vision therapy treatment.

What Kind of Vision Problems Result From a Brain Injury?

female lookingOften the affected person with a TBI is not aware of their specific vision dysfunction but might complain of one or more of the signs below:

Traumatic Brain Injuries tend to interrupt the communication between the eyes and the brain, which can cause a range of visual dysfunctions. The signs often include:

  • Blurred vision
  • Eyestrain
  • Sensitivity to light
  • Reading difficulties
  • Attention and concentration difficulties

Below is a more detailed list of the common vision problems that can result from brain injury or a medical condition, such as a stroke, tumor, aneurysm, meningitis, cerebral palsy, and other neurological insults.

  • Visual Acuity – Blurry vision, either all the time or can shift in and out of focus.
  • Eye focusing – Inability to quickly change focus from near to far objects.
  • Eye teaming – The eyes not working in tandem, potentially causing double vision.
  • Eye movements – Difficulty following a moving object or losing one’s place while reading.
  • Motion sensitivity – The disruption of the connection between vision integration and balance system which makes it difficult to process motion properly. This can cause vertigo or unease when traveling, scrolling a digital device, or when in busy environments such as grocery stores, social settings, or sporting events.
  • Visual Field Loss – The partial or complete loss of peripheral vision. Visual field loss may cause one to bump into objects, be struck by approaching objects, or experience frequent falls.
  • Visual Memory Loss – Losing the ability to recall or remember visual information stored in long or short-term visual memory. This can have a devastating impact on daily functioning as the individual no longer recalls numbers, words, pictures, or any data viewed in the past. Reading comprehension decreases, and the ability to recognize locations and faces declines. One may not remember where a specific object—such as a car key—was put or how to give directions.
  • Headaches or Eye Pain – Following head trauma, the individual may experience a range of headaches or even a stabbing pain around the eye — at times accompanied by redness, burning, or itching of the eyes
  • Sensitivity to Light – In the aftermath of a brain injury, one can develop sensitivity to light and be unable to tolerate glare. Also known as photophobia, sensitivity to light can be exacerbated by particular light sources, such as bright sunlight and fluorescent lighting. LCD screens, used for computers or smartphone devices, can be particularly intolerable after a concussion.

two friends talkingHow Can Neuro-Optometric Rehabilitation Optometry Help You Recover From a Brain Injury?

People of all ages who develop visual dysfunction due to a neurological trauma or injury can benefit from a vision assessment by a Neuro-Optometric Rehabilitation Optometrist (neuro-optometrist). These eye care professionals are highly trained in the diagnosis, treatment and rehabilitation of neurological conditions that affect the visual system, as well as perceptual and motor disorders. Research studies show that patients having undergone a vision rehabilitation program can vastly improve their quality of life.

An interdisciplinary rehabilitation team is essential for patients with concussions, strokes or other neurological deficits. In addition to optometrists, team members may include nurses, physical therapists, occupational therapists, speech-language pathologists, physical medicine doctors, neurologists, neuropsychologists, audiologists, and ophthalmologists, among others.

The Fox Vision Development Center regularly assists patients in retraining their visual system to overcome symptoms and visual conditions caused by brain injury. If you are suffering from any of the above symptoms or conditions, please reach out to us.

Our practice serves patients from Latham, Albany, Glens Falls, and Troy, New York and surrounding communities.

Request A Functional Visual Exam
Find Out How We Can Help You! 518-374-8001

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Acquired Brain Injuries

Acquired brain injury (ABI) is an injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma. The brain’s neuronal activity changes as a result of the injury, affecting the physical integrity, metabolic activity and functional ability of nerve cells in the brain.

What Causes Acquired Brain Injury (ABI)?

There are many ways a person can experience an ABI, including:

  • Alcohol or drugs – excessive consumption can cause brain damage
  • Diseases – such as brain cancer, Alzheimer’s disease, multiple sclerosis and Parkinson’s disease
  • Lack of oxygen – called anoxic brain injury, usually caused by near-drowning, choking or suffocation
  • Physical injury – such as an impact or blow to the head, which may occur during a fall, in a sporting or vehicle accident, or from an assault
  • Stroke – such as an embolism or other blockage of the blood vessels or a transient ischemic attack (TIA)

How ABI affects a Person’s Vision

ABI’s can significantly impact the functioning of the visual system. While certain brain injuries may cause permanent damage to the optic nerve, it’s more common for it to disrupt the pathways that enable communication between the eyes and brain.

Visual problems may include:

  • Dizziness
  • Double vision
  • Focusing problems
  • Headaches
  • Problems with walking and stride

Treatment for Vision Affected by ABI

Neuro-optometrists offer a customized treatment regimen for people with visual deficits resulting from acquired brain injuries.

First of all, your neuro-optometrist will assess your vision and visual skills during a comprehensive neuro-optometric exam. Based on those findings, your doctor will design a neuro-optometric rehabilitation program to address your specific needs. The focus of the treatment will be managing low vision and vision rehabilitation to improve functioning, including any learning disorders.

The goal of neuro-optometric rehab is to minimize visual disability so that a patient can carry out daily activities like walking, reading and driving.

Neuro-optometric rehab utilizes special prescription lenses, prism lenses or patching, depending on the visual problem that needs treatment.

With the right treatment paired with a customized neuro-optometric rehabilitation program, many patients find that their symptoms improve almost immediately, leading the way toward long-term healing. For more information about neuro-optometry please contact Fox Vision Development Center or to schedule a neuro-optometric vision evaluation.

Our practice serves patients from Latham, Albany, Glens Falls, and Troy, New York and surrounding communities.
Request A Functional Visual Exam
Find Out How We Can Help You! 518-374-8001