Traumatic Brain Injury and Neuro-Optometric Rehabilitation
Neuro-optometric rehabilitative care involves extensive optometric assessment to identify visual dysfunctions and ocular health issues resulting from acquired brain injuries, especially head trauma and stroke, and neurologic disease such as multiple sclerosis and Parkinsonian conditions. The effects of these visual and ocular problems on activities of daily living (ADLs) and a person’s quality of life (QOL) can be identified by an extensive history and communication with others involved in the person’s rehabilitative care. Optometric rehabilitative management is programmed to improve visual dysfunctions to reduce or eliminate impediments to ADLs, and to improve QOL, as well as to inform other health professionals of the possible visual effects on their treatment, to minimise visual interference with physical rehabilitation.
Visual problems can include reduced visual acuity, binocular vision issues and diplopia, convergence and accommodation and eye movement dysfunctions, photophobia and pattern glare, and visual field loss. Ocular problems can include retinal damage and field loss, optic atrophy and effects on colour vision and contrast, and diplopia.
Optometric rehabilitative care may involve spectacles, prisms, vision therapy, tinted lenses, and visual field loss aids.
The presentation will evolve from a number of case studies to demonstrate the principles and practice of neuro-optometric rehabilitative, assessment and management and the efficacy of optometric intervention to improve ADLs and QOL.
1 Become familiar with the signs and symptoms presenting in everyday patients, which suggest the possibility of visual or ocular effects of pre-existing neurological issues such as stroke, head injury, concussion, and neurological diseases such as Parkinson’s disease.
2 Improve awareness of questions and techniques to obtain an appropriate history to elucidate patient symptoms which may be neurological in origin.
3 Obtain a better understanding of sequential optometric assessment of visual dysfunctions and ocular health issues which can occur due to acquired brain injuries, the potential effects on a person’s activities of daily living and the options for optometric care.
Stephen Leslie is in private practice in Perth Western Australia, where he concentrates on care of vision and ocular problems related to health issues, and subsequent to acquired brain injuries following stroke, head trauma, or neurological disease such as multiple sclerosis and Parkinsonian conditions. He served as National President of the Optometrists’ Association of Australia 1991-1992, and as a National Councillor of the OAA for 15 years, and was awarded life membership of the OAA (WA) in 1997. He is currently National President of the Australasian College of Behavioural Optometry (ACBO). He is regularly called on to provide medicolegal reports for lawyers regarding clients who have suffered head injuries due to motor vehicle accidents, falls or assaults, as well as expert opinions in medicolegal issues involving optometrists.