Vision Recovery

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Key Facts

  • Approximately 30% of all stroke patients suffer from post-stroke visual impairment. Sand KM. Acta Neurol Scand Suppl. 2013.
  • Visual field loss is the most common disorder. National Stroke Association.
  • Hemispatial visual neglect affects up to two thirds of right hemisphere stroke patients acutely. Robertson IH et al. Psychology Press, 1999.

Vision Recovery Research Findings

  • Computer-based scanning therapy, such as Visual Motor Training and Virtual Reality/Exercise Games can improve visual neglect.
  • Wearing Visual Aids, like Prisms, may improve functional performance with every-day tasks. Prisms can be used to reduce the apparent visual field loss by shifting visual stimuli from the blind field into the patient’s seeing field. These prisms are fitted to glasses but need to be restricted to just one half of each of the lenses (typically on the side of the blind field).
  • Visual scanning techniques can improve visual neglect with associated improvements in function.
  • Compensatory training (adapting to the vision loss) can significantly improve search performance and efficiency.

 

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Vision Recovery Outcome Measures

    • Albert’s Test – In this test, patients must cross out lines that are placed in random orientations on a piece of paper. Unilateral spatial neglect is indicated when lines are left uncrossed on the same side of the page as the patients motor deficit or brain lesion is located.
    • Behavioral Inattention Test – The BIT, initially called as Rivermead Behavioral Inattention Test, is a short screening battery of tests to assess the presence and the extent of visual neglect on a sample of everyday problems faced by patients with visual inattention.
    • Bells Test – The Bells Test is a cancellation test that allows for a quantitative and qualitative assessment of visual neglect in the near extrapersonal space.
    • Line Bisection Test – The Line Bisection Test is a test is a quick measure to detect the presence of unilateral spatial neglect (USN). To complete the test, one must place a mark with a pencil through the center of a series of horizontal lines. Usually, a displacement of the bisection mark towards the side of the brain lesion is interpreted as a symptom of neglect.
    • Motor-Free Visual Perception Test – The Motor-Free Visual Perception Test (MVPT) is a widely used, standardized test of visual perception. Unlike other typical visual perception measures, this measure is meant to assess visual perception independent of motor ability. It was originally developed for use with children (Colarusso & Hammill, 1972), however it has been used extensively with adults. The most recent version of the measure, the MVPT-3, can be administered to children (> 3 years), adolescents, and adults (< 95 years) (Colarusso & Hammill, 2003).
    • Occupational Therapy Adult Perceptual Screening Test – The OT-APST is a standardized screening measure that enables occupational therapists to test for the presence of impairment in visual perception across each of the major constructs of visual perception and praxis, including the problems most frequently occurring after stroke.
    • Ontario Society of Occupational Therapists Perceptual Evaluation – The Ontario Society of Occupational Therapists (OSOT) Perceptual Evaluation was designed to assist in the detection of perceptual impairment in adults who have experienced brain damage caused by traumatic brain injury or stroke. The OSOT assesses perceptual dysfunction in areas related to basic living skills. The measure is also used to determine the degree of impairment, to monitor change, and to measure the effects of treatment and/or spontaneous recovery. The OSOT has been standardized for use with individuals aged 40-69 years.
    • Single Letter Cancellation Test – The Single Letter Cancellation Test (SLCT) is used to evaluate the presence and severity of visual scanning deficits, and is used to evaluate unilateral spatial neglect (USN) in the near extrapersonal space.

Looking For A Vision Specialist?

Neuro-Optometric Rehabilitation Association (NORA) is diverse group of professionals dedicated to advancing the art and science of rehabilitation of the neurologically and cognitively injured and disabled survivor population and their families. NORA members are professionals who recognize the crucial role of vision in human performance. NORA emphasizes treatment modalities designed to optimize the frequently neglected visual-motor, visual-perceptual and visual information processing dysfunction in the neurologically affected person.

There exists, within the profession of optometry, a group of concerned and highly trained professionals uniquely skilled and experienced in the technologies of neuro-optometric rehabilitation/habilitation of the persons affected. Integration of these unique Neuro-Optometric treatment modalities maximizes the potential of the rehabilitation team within a multidisciplinary approach.

 

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References

Evidence-Based Review of Stroke Rehabilitation

Stroke Engine