Vision problems after a traumatic brain injury or stroke can be of serious concern to patients. With a traumatic brain injury, in which the patient sustains an impact to the head that causes injury to the brain, vision problems, such as blurred vision, can occur even when the injury is mild. Patients who have a stroke, a neurological condition in which the blood supply in the brain becomes disrupted, can have various vision problems, include double vision, decreased vision or a loss of vision. In a booklet published by the Australian Government's Department of Health and Ageing, up to 30 percent of patients who have a traumatic brain injury or stroke have a visual impairment. These post-brain injury visual impairments can include difficulty recognizing objects, being unable to see on one side, blurred vision and increased glare sensitivity.
So how are these visual impairments associated with a traumatic brain injury or stroke treated? Patients may undergo different therapies to help increase their vision. Options include compensatory scanning training, prisms and vision restorative therapy. With compensatory scanning training, patients use equipment that teaches them “to systematically turn their head to look into their affected side, thus compensating for their vision loss,” according to the Australian Government's Department of Health and Ageing. Prisms can help shift an image into the unaffected part of a patient's visual field. Another treatment is vision restorative therapy, which uses a computer program to help treat the vision loss. One type of vision restorative therapy is from NovaVision, which is cleared by the U.S. Food and Drug Administration, according to a press release from the company.
This type of vision rehabilitation uses a computer for neuro-stimulation, improving vision through neuroplasticity, which the University of Washington defines as “the ability of the brain to change with learning.” In the press release about the treatment, the company notes that about 88 percent of patients exhibit an improvement with at least one daily functional activity and that the time between the injury and the start of the rehabilitation does not impact treatment. But this treatment is not without its controversies. In a 2005 article published in the British Journal of Ophthalmology, author J.C. Horton noted several issues that arose in an earlier clinical trial with this treatment, including no information of false positives and negatives, and reported that the treatment was effective for two conditions: homonymous, post-chiasmal lesions and monocular optic nerve diseases, which are at different levels in the visual system. As with any new treatment, always talk to your doctor first.
National Institute of Neurological Disorders and Stroke (NINDS): Traumatic Brain Injury: Hope Through Research (http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm)
MedlinePlus Medical Encyclopedia: Stroke (http://www.nlm.nih.gov/medlineplus/ency/article/000726.htm)
The Royal Society for the Blind and the Australian Government's Department of Health and Ageing: Neurological Vision Loss, A Guide for People Who Have a Homonymous Hemianopia (http://www.trinity.edu/org/sensoryimpairments/VI/RandR/Neurological%20Vision%20Loss.pdf)
NovaVision Press Release: Vision Therapy the “Unmet Need” for Stroke and Traumatic Brain Injury Rehabilitation (http://www.biospace.com/news_story.aspx?StoryID=211484&full=1)
University of Washington: Brain Plasticity: What Is It? (http://faculty.washington.edu/chudler/plast.html)
The British Journal of Ophthalmology; “Disappointing Results from Nova Visions' Visual Restoration Therapy”; J.C. Horton; January 2005 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772467/)