by Cathy Stern, OD, FCSO, FCOVD, FNORA
The field of neuro-optometric rehabilitation and vision therapy is rapidly expanding in response to new diagnostic technology and a better understanding of the visual aspects of concussion and other types of brain injury, such as stroke.
But primary care optometry referrals for vision therapy lag behind — in part because of myths about this field.
Myth #1: Vision therapy is just for children
The reality is that vision therapy and rehabilitation can help people of all ages improve visual function across a wide range of needs. Certainly, children’s ability to read and perform in school is a major indication, but adults recovering from a concussion, stroke or other brain injury; athletes looking to improve performance on the field; and patients with neurological conditions such as Parkinson’s, autism, or multiple sclerosis all can benefit from rehabilitating or training certain visual skills. And, as neuroscientist Susan R. Barry, PhD, taught us in her memoir, Fixing My Gaze, the brain is plastic enough that it is still worth trying to correct problems like amblyopia.
Myth #2: Therapy/rehabilitation is all about input
Many optometrists associate vision therapy only with conditions such as eye turn and amblyopia — in other words, those associated with visual inputs. But much of the work that I do actually goes well beyond that and is related to visual-vestibular performance and visual processing. I often work with patients on skills like eye tracking, eye teaming, the ability to shift one’s gaze from the board or a screen to the page and back, near convergence, balance and proprioception. All of these visual skills (or lack thereof) can benefit from training and rehabilitation.
Myth #3: Low vision care and vision therapy are mutually exclusive
We typically think of the low vision specialist as the person who prescribes magnification devices for patients with sight impairment due to macular degeneration or retinopathy. While it is true that low vision specialists focus primarily on optical and nonoptical aids for sight and orientation, low vision services can also be very helpful for patients who have temporary field loss or double vision due to stroke or brain injury. Likewise, neuro-optometric rehabilitation can help patients be more successful with their low vision aids.
Lack of awareness about vision therapy can often delay treatment for patients, sometimes for years, as Amy Zellmer noted in her blog post. I would love to see primary care optometrists be more aware of the types of services that low vision and vision therapy/rehabilitation professionals in their area offer so that optometrists can refer their patients of all ages to their colleagues who can best help them maximize visual function.
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Cathy Stern, OD, FCSO, FCOVD, FNORA , is a developmental and behavioral optometrist with specialized training in learning-related vision problems, vision rehabilitation, computer vision syndrome and sports vision training. She maintains a private practice in Canton, Mass., limited to the diagnosis of developmental and behavioral vision problems and treatment of children and adults with vision therapy and vision rehabilitation.
Disclosure: Stern reports no relevant financial disclosures.
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