The Neuro-Optometric Rehabilitation Association International is an interdisciplinary group of professionals dedicated to providing patients who have physical or cognitive disabilities as a result of an acquired brain injury with a complete ocular health evaluation and optimum visual rehabilitation education and services to improve their quality of life.

BLOG: It takes a village

by Shirley Ha, HBSc, OD, FCOVD

In neuro-optometric rehabilitation we use a number of tools to address visual deficits that have occurred as a result of physical disabilities, traumatic brain injuries and other neurological insults. Among these tools are therapeutic prisms, lenses, tints, filters and occlusion.

While these can work wonders, they are often just one step on a patient’s journey. An integrated team approach that harnesses the training and expertise of a variety of professionals can play a vital role in rehabilitation.

Such an interdisciplinary team might include a vision therapist, physical or occupational therapists, a chiropractor, audiologist or speech pathologist, and medical colleagues in ophthalmology, neurology or internal medicine.

Shirley Ha
Shirley Ha

In some cases, a psychiatrist or psychologist is brought in to help with depression or cognitive issues related to the brain injury. Consider a patient who has suffered a stroke or traumatic brain injury. While neurorehabilitation can help them function better, the individual may still have difficulty accepting visual or functional losses that are more permanent and cannot be regained.

Working with a physical therapist is among the most common scenarios for a neuro-optometric rehabilitation optometrist. Vision is the dominant sense and, as such, it guides motor activity. Visual processing problems, therefore, often lead to difficulty ambulating or balancing.

A stroke patient I worked with, for example, had one arm contracted to his chest and walked with a swivel-like motion, with the stroke-affected side held very rigidly and the leg on that side dropping down with each step. By applying the correct amount of yoked prism, I was able to stabilize his visual processing. Although he immediately started walking more normally, time spent with a physical therapist ensured that progress continued.

There are wonderful opportunities to collaborate with other specialties, acknowledge each other’s training and expertise, and work together for the benefit of our patients.

The NORA website features a listing of North America-based (U.S. and Canada) and international professional associations and organizations where you can find additional information about the various professionals who make up interdisciplinary rehabilitation teams and the services that each offers.

For more information:

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

Disclosure: Ha reports no relevant financial disclosures.