Vision therapy, also known as neuro-optometric rehabilitation, corrects or improves visual conditions caused or exacerbated by concussion. This type of treatment can be thought of as physical therapy for certain aspects of the visual center of the brain. The goal of vision therapy is to strengthen the connection between the eyes and the brain for improved visual skills at work, school and sports.
Our neuro-optometrists who are board certified in vision therapy create individualized treatment programs using lenses, prisms, 3D activities, and other specialized instrumentation to address lingering concussion symptoms such as: double vision, blurred vision, eye strain and fatigue, light sensitivity, headaches, dizziness, nausea, difficulty tracking moving objects and loss of place when reading.
Underlying conditions that can be exacerbated by concussion include: amblyopia, or lazy eye; strabismus, or wandering/crossed eyes; binocular vision; tracking disorders and perception problems. These are addressed within the treatment program and typically consist of one or two sessions per week for 14-24 weeks along with an associated home program.
School woes caused by vision disorder
Please help me get the word out about a common condition that severely affects children's ability to succeed in school because it inhibits reading, spelling and concentration.
My daughter, who was obviously bright, tested at first-grade reading level in fifth grade. She had undergone all the school testing for learning disabilities, plus two days of testing at a respected university hospital. None of these tests or specialists revealed what could be wrong with her.
My child's self-esteem suffered. Her confidence faltered; she began acting out in school. At home she was a great kid, until it came time for schoolwork. Then the battles began. She thought she was dumb. When studying, she could read for only a very short time. She often begged me to read things to her. When working on spelling and assigned to rewrite the words she missed five times, she often recopied them wrong. We thought she just wasn't trying.
After much research on the Internet, I came across a disorder called "convergence insufficiency disorder." This visual condition is the leading cause of eyestrain. Fortunately, we had the opportunity to have her tested at the Mayo Clinic, where her condition was confirmed, and she was successfully treated with vision therapy.
It was as though a miracle had occurred. After six months of treatment, my daughter is almost at her age-appropriate reading level. Her comprehension and retention have markedly increased, and her self-esteem and attitude about reading are much better.
Children with this condition will not benefit from tutoring, special education or extra help from teachers until the condition is diagnosed and treated. My child had 20/20 vision and still had this disorder. It's not routinely checked with eye exams, and schools don't test for it.
I suspect that many children out there are undiagnosed or misdiagnosed and going untreated. The treatment for convergence insufficiency disorder is noninvasive, effective, and much of it can be done at home. Please help me get the word out so other families won't have to go through what we experienced. -- Angie W. in Minnesota
I am pleased to help you get the word out to other families whose children are struggling to learn. After reading your letter, I contacted my experts at the Mayo Clinic in Rochester, Minn., and was informed that this problem, where the eyes drift too much inward (or outward) in attempting to focus, can also be present in adults.
The symptoms can include eyestrain, headaches, blurred vision, sleepiness and trouble retaining information when reading. Other symptoms associated with convergence insufficiency include a "pulling" sensation around the eyes, the rubbing or closing of one eye when reading, words seeming to "jump" or "float" across the page, needing to reread the same line of words, frequent loss of place, general inability to concentrate and short attention span.
The good news is: Vision exercises can fix the problem in most cases, some done at home and some performed in-office with a vision therapist. Prism glasses are another option; however, they are more often prescribed for adults with this disorder than for children.
Going Binocular: Susan's First Snowfall
National Public Radio, Morning Edition, June 26, 2006
This story begins with a chance conversation. Susan Barry, professor of neuroscience at Mount Holyoke College, was at a party when she happened to bump into Dr. Oliver Sacks. Sacks is a polymath. He's a physician and an author (The Man Who Mistook His Wife for a Hat, and Awakenings). His work has been turned into plays (one by Harold Pinter), short stories and movies (Robin Williams played him). He is also a marathon swimmer, a lover of ferns — and, as it happens, he is fascinated by stereoscopy.
Stereopsis is the ability to perceive depth and space. So instead of seeing something as flat, in two dimensions, when you see in stereo you see it in three dimensions. Some people find stereovision completely fascinating. So because Dr. Sacks has this enthusiasm, he was intrigued at the party when Susan Barry mentioned that she had been born cross-eyed. The problem wasn't surgically treated until she was past her second birthday.
Apparently, that two-year pause was crucial, because when she got to college, Barry learned that if baby cats or baby monkeys are cross-eyed during infancy, their eyes don't learn to work together and therefore their binocular brain cells don't develop and they lose the chance to see in stereo. The loss is forever, and what happens to baby cats, the professor said, happens to baby humans.
"Like me?" Barry wondered. She never imagined that she saw differently from other kids. But after the professor raised the question, Barry got herself tested and discovered she was indeed monocular. She could not see depth or space the way the rest of us do.
All this she told Oliver Sacks. She also told Sacks that she didn't think she was missing very much, not seeing in stereo. And that's when Sacks leaned in really close and said, "Do you think you can imagine what it's like to see the world with two eyes?"
Well, miracles do happen. Barry found out what it's like. And she wasn't imagining.
Near the approach of Barry's 50th birthday, Barry met Dr. Theresa Ruggiero, an optometrist who specializes in vision therapy. Barry started a vision therapy program and will never forget the astonishing moment some months later when against all expectations, her vision suddenly — after a half century — popped into 3-D. You can hear her amazing account of this moment on National Public Radio Morning Edition website by clicking here. Barry's vision is also the subject of an Oliver Sacks essay in the New Yorker magazine. For an abstract, click here.
Barry's experience, it turns out, is not unique. Apparently other people have spent their lives with visual deficits expected to last forever and, through vision therapies suggested by their eye doctors, they say they have gotten back some of the sense they had lost.
What is especially fascinating about all these stories is they suggest that brains are more "plastic" — more changeable and repairable in adulthood — than many scientists and doctors had thought.
For a long time, leading neuroscientists taught that there is a brief "critical period" in infancy when a baby brain can rewire itself and change; when that period ends, change stops.
It would follow that if you are born cross-eyed and do nothing about it until you are 2 years old, you can never learn to see in stereo. Barry's story (and the others if they prove to be true) suggest that while baby brains are more malleable than adult brains, adult brains are not frozen in place.
Vision can change. Barry's did.
If you would like more information on learning-related vision problems, contact the national offices of Parents Active for Vision Education (PAVE), a nonprofit organization whose mission is to educate parents and teachers on the vital role vision plays in the learning process. Their toll free number is 1-800-PAVE-988.