BLOG: What is neuro-optometric rehabilitation?

by Shirley Ha, HBSc, OD, FCOVD

As optometrists, we all have the good fortune to be able to help patients optimize sight, their dominant sense. Typically, this is done through prescribing contact lenses or glasses to correct refractive error, as well as by managing ocular diseases and conditions that can affect the visual pathway of light to the retina.

However, vision encompasses far more than this. In order for objects and symbols to be seen and understood, factors such as gaze, attention, motivation, eye tracking, binocularity and visual processing by the brain all come into play.

And because the visual system is integrated into proprioception, posture, spatial awareness, motor output, memory, cognition and behavior, problems in any of these areas can have wide-ranging effects on daily activities and on quality of life.

The small but growing field of neuro-optometric rehabilitation addresses all these subtle factors involved in the complex visual process. Neuro-optometric rehabilitation involves a targeted, individualized treatment regimen for those who have a myriad of visual deficits as a direct result of physical disabilities, traumatic brain injuries and other neurological insults and/or diseases. It is different from vision therapy, although many neuro-optometric rehabilitation specialists have a background in vision therapy.

Step 1: Diagnosis

Neuro-optometric rehabilitation optometrists have special training to understand how specific visual dysfunctions relate to a patient’s symptoms and performance, and our functional exams are very different from a typical primary care eye exam.

For example, we may incorporate sensory motor evaluations, visual perceptual skills testing, low vision testing, expanded visual field assessment or electro-diagnostic testing using a Diopsys system to measure visual evoked potential.

Step 2: Treatment

The next step is to identify a course of action based on brain plasticity that will resolve symptoms and improve function. Treatments may include therapeutic prisms, lenses, tints, filters or occlusion. In addition, we often work closely with an integrated team of other professionals to help the patient with, for example, motor or speech skills at the same time. (Stay tuned for more on the team approach in a future blog).

We often see patients who have been suffering from vision-related symptoms or limitations without ever being properly diagnosed or treated. For these patients, knowing there is an explanation — and a path forward through neuro-optometric rehabilitation — can be transformative and empowering.

For more information:

Shirley Ha, HBSc, OD, FCOVD, who practices in Burlington, Ontario, is the Membership Committee Chair for the Neuro Optometric Rehabilitation Association (NORA) and a member of the board of the Canadian Optometrists in Vision Therapy and Rehabilitation.

Disclosure: Ha reports no relevant financial disclosures.

For more information, visit noravisionrehab.org or consider expanding your own awareness and clinical skills at the Neuro-Optometric Rehabilitation Associat ion annual conference, Sept. 20-23 in St. Louis.