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: New technology for concussion and visual function

by Charles Shidlofsky, OD, FCOVD

We are fortunate that new technology is lowering the barriers to testing and treating patients with brain injuries and other visual function problems.

Here, I’ll review some of the creative technologies that optometrists, vision therapists and neuro-optometric rehabilitation specialists might want to consider for their practices.

Among the most useful new assessment tools is the RightEye EyeQ platform, with four different tests geared towards reading, sports vision, functional vision and brain health. These quick tests, which include horizontal and vertical pursuits and saccades, circular pursuits, fixation and sensory motor evaluation, are objective tests for eye movement that rely on precise eye tracking in free space. They provide the clinician with immediate analytics that are helpful in guiding therapy, measuring progress and educating patients. The Brain Health EyeQ test, for example, provides an overall functional score, color-coded visual skills grading (green = normal, yellow = below normal levels, red = significantly below normal levels), as well as an indication of which eye muscles and/or parts of the brain may be affected.

Charles Shidlofsky
Charles Shidlofsky

Another new tool I’m excited about is BTrackS from Balance Tracking Systems. This posturography device helps isolate the three components of balance (vestibular, visual and tactile) using a balance board with firm and soft surfaces. Although I have been using posturography for 20 years, this new tool is about one-seventh of the cost of earlier systems, making it much more accessible. It also measures changes electronically, making it easier to quantify how yoke prism lenses or other therapeutic lenses or occlusion techniques can improve balance.

With the explosion of virtual reality (VR) consumer technology, many optometrists are also looking at VR for the office. There are two virtual reality training systems to consider: Vivid Vision and Optics Trainer. Although there are some pros and cons to each, both of these systems are excellent training tools for vergence, acuity, stereopsis, antisuppression and perceptual learning. They can be used with children and adults with amblyopia or brain injury.

I also like CBS Health, from Cambridge Brain Sciences, a web-based platform for assessment of cognitive function. Although it is qualitatively similar to concussion testing programs like ImPACT and CNS Vital Signs that are used by schools and primary care physicians, CBS Health can be customized to patients’ and practitioners’ needs. For example, I can select specific visual-spatial tasks from the 12 tests offered and see the patient’s performance compared to population norms.