Vision Therapy: Perceptions, Barriers, and Benefit

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Our brains dedicate more than half of their outer tissue to vision and vision processing [1]. With an estimated 90% of traumatic brain injury (TBI) survivors suffering vision or vision processing issues—and millions of TBIs occurring each year—hundreds of thousands of individuals are left with impairments to their most crucial sense: sight [1]. To make matters worse, a significant proportion of brain injuries go underdiagnosed and unreported.

Vision therapy—a rehabilitative practice to correct damage to the brain’s vision-related functions—has a plethora of scientific studies showcasing its effectiveness for TBI survivors. Despite the robust body of scientific credibility, vision therapy is an underutilized resource in the brain injury community. While a lack of awareness about TBIs can be blamed for some of this shortcoming, there are other reasons why brain injury survivors might not be considering vision therapy for their own rehabilitation. It’s time to unravel some of those reasons.

Alex Becker, a law student with a history of multiple concussions and TBI, has been undergoing vision therapy for two months and has experienced tremendous benefits from the practice. Brian Gurry—television host of American Builder and TBI survivor— is hesitant to begin vision therapy despite completing an intake which illuminated the benefits he could reap. Looking closely at Alex and Brian’s unique journey provides insights into the vision therapy experience, perceptions around the practice, barriers that may be holding people back, and the benefits of sticking with it.

 

Perceptions around vision therapy

Before trying vision therapy, Alex Becker had jumped through the hoops of an upper cervical chiropractor, a neurology specialist, and a vestibular therapist to alleviate her severe brain injury symptoms—not to mention all the medications she was given. With minimal progress with these rehabilitative therapies, Alex made the decision to tackle life without continuing therapy when her rigorous academic semester began. Unfortunately, she quickly found herself “walking two miles to and from school every day because [she] couldn’t get on a subway without serious nausea, headaches, and blurred vision.” With so many different therapies under her belt—with varying degrees of efficacy for her symptoms—one might expect Alex to be hesitant about jumping into vision therapy. Fortunately, she had been vicariously exposed to vision therapy through her sister’s TBI experience, which alleviated a lot of skepticism:

 

I knew that my sister could barely see anything in one eye when she started [vision therapy] and by the end—after a lot of hard work—she could see in both eyes again. It was huge!

 

While Alex was able to source optimism from her sister’s experience, Brian Gurry hasn’t been so fortunate—or willing. Power of Patient’s CEO and founder, Lynne Becker, introduced Brian to vision therapy and helped him complete a virtual intake with neuro-optometry specialist Dr. Yamam Almoradi. In just 90 minutes over two days, Dr. Almouradi was able to assess Brian’s visual efficiency (how well the eyes work together) and his visual information processing (how well your brain and eyes communicate). While Brian exuberantly assigned himself an “A+” after finishing the examination, Dr. Almouradi had other ideas—noting impairments to both his visual efficiency and visual information processing. Despite the many ways vision therapy could benefit Brian, he has not yet tried the rehabilitative practice in earnest—putting him in the same boat as many other brain injury survivors.

 

Dr. Almouradi hears Brian’s favorite excuse, that he’s ‘too busy,’ all too often when they discuss vision therapy. Are you too busy to improve your vision and live a better life?”

 

Perceived challenges around vision therapy—with potential solutions

There are a number of reasons why a brain injury patient might be hesitant to dive into vision therapy. The first reason was offered by Brian himself: it takes time! In the busy world we are all familiar with, time is precious and many people find themselves hard pressed to add another routine to their daily or weekly schedule. This was an argument Alex Becker used to use, but after encouragement from her mother, things began to change for the better.

Despite the pressure of her school’s intensive legal curriculum, Alex offers an inspiring solution for individuals cramped on time. When questioning how to add 20 minutes of vision therapy into her busy schedule, Alex answers, “I don’t have to watch TV, I could just put it on the background!” While this quick-fix may be unique to Alex’s lifestyle, she offers other broadly adoptable practices as well. Alex recommends writing your vision therapy exercises and goals on a physical piece of paper and crossing them off as you tackle them day by day. This strategy offers patients organization, accountability, regularity, and a little bit of encouragement every time another exercise is scratched off the list. The Power of Patients Dashboard makes this process even easier with convenient symptom tracking and customizable reminders for brain injury survivors.

Another barrier brain injury survivors may face when considering vision therapy is the unfamiliarity of it all. As Alex says herself when discussing the surprising impact of one of her exercises, it “feels like pseudoscience!” Without a professional understanding of neuro-optometry, the intake, exercises, and experience of doing vision therapy can feel very unusual and even silly at times—which may deter a patient’s faith in the process. For these individuals, it is important to remember that vision therapy is a true science, with numerous articles confirming not only its legitimacy, but also its utility for brain injury survivors.

When Alex says “pseudoscience” she really means syntonics! The College of Syntonic Optometry describes the practice as:

the branch of ocular science dealing with the application of selected light frequencies through the eyes. It has been used clinically for over 80 years in the field of optometry with continued success in the treatment of visual dysfunctions, including strabismus (eye turns), amblyopia (lazy eye), focusing and convergence problems, learning disorders, and the after effects of stress and trauma.” 

While the aformentioned obstacles pertain mostly to patients who have not yet tried vision therapy, other bumps can arise for individuals already on the path of vision therapy. Alex forewarns, “There are going to be hard days where you want to quit and there’s going to be times where you think, ‘this isn’t doing anything.’” Some of the exercises can be uncomfortable, eliciting undesirable symptoms of their own. In some cases, these experiences arise from the brain undoing incorrect healing that occured in absence of professional therapies. Healing the brain is comparable to training muscles: when you push your current limits you feel sore, tired, and ready to quit.

To anyone in the aforementioned predicament, Alex “would encourage you to keep trying. There’s always another day.” It is important to keep putting one foot in front of the other when it comes to rehabilitating the brain. While it may be hard to recognize in the moment, each day of vision therapy is a step closer to an improved quality life—which Alex can readily attest to.

 

The outcomes of vision therapy—inspiration for all

When Alex first began vision therapy, she was experiencing a very low quality of life. Perpetual migraines, an inability to focus while reading, jumping vision, and blurred sight at various distances are just a few of the symptoms Alex struggled with day after day. The combination of these manifestations even made walking difficult—something she had never been challenged by before. Other symptoms were evident to Alex’s family, such as a dampened personality and shortened temper. When beginning vision therapy, certain tests made her vision-related shortcomings even more blatant. Alex recounted one exercise where she was asked to look at a page with ten dots. With both eyes or her left eye, she could see all the dots clearly. With her right eye, Alex couldn’t even see the first dot—which her doctor explained to indicate a lack of communication between her brain and right eye.

With only two months of vision therapy—a relatively short period of time—Alex describes the difference in her daily life as “night and day.” Not only has Alex’s vision score improved, but she repeated the aforementioned activity and can now see two of the ten dots with her right eye! In regards to her doubling vision and intermittent loss of depth perception, Alex was given a simple eye cooperation exercise. For this, she reads from a screen and holds up a pencil between her eyes and the screen. While continuing to read the words behind the pencil—which appears doubled—the exercise “pulls [her] depth perception right back in.”

 

They’re small steps, but they’ve caused significant changes in the well being of my life. There’s still work to do, but I’m at a point where the symptoms are so under control that I can still function and work on it without it being a serious stress.

 

Alex’s perseverance and diligence with vision therapy has yielded leaps in her quality of life, with more benefits anticipated to arise as she continues the practice. With this in mind, you can imagine what she would say to someone like Brian, whose less-than-optimal quality of life remains stagnant without vision therapy. For people like Brian, or others who are hesitant to begin, Alex has a few closing tips and remarks:

  1. Research your vision therapy specialist—finding a good doctor makes the biggest difference in Alex’s experience
  2. If your first consultation seems questionable, get a second opinion! If you hear the same thing twice, it’s more likely than not that vision therapy can benefit you.
  3. Be open minded—some aspects of vision therapy can seem silly or too simple to work. As Alex will tell you, “it sounds crazy,” but the results are “absolutely wild!”

 

If you’re deciding whether vision therapy is right for you, and need a place to start, check out our vision symptom assessment tool here.

 

[1] Complete Eye Care (2020). Vision and Traumatic Brain Injury. Retrieved November 11, 2020, from https://www.completeeyecare.net/eye-care-services/vision-therapy-faq/vision-and-traumatic-brain-injury/

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