Purchase this article with an account.
K. J. Ciuffreda, D. Rutner, N. Kapoor, I. Suchoff, S. Craig, E. Han; Oculomotor Rehabilitation in Acquired Brain Injury. Invest. Ophthalmol. Vis. Sci. 2007;48(13):902.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Oculomotor dysfunctions are one of the most common abnormalities found in the brain-injured population, occurring in up to 90% of these individuals, yet relatively little is known about their remediation. Thus, the purpose of the present study was to determine retrospectively the efficacy of clinical oculomotor rehabilitation for eye movement disorders of version and vergence in a sample of ambulatory, visually-symptomatic, adult outpatients having either traumatic brain injury (TBI) or cerebrovascular accident (CVA).
A computer-based query for acquired brain-injury patients examined in our clinic between the years of 2000 and 2003 was conducted. This yielded 160 individuals with TBI and 60 with CVA. Of these patients, only those that were recommended and completed the clinic oculomotor rehabilitation program were selected. This yielded 33 with TBI and 7 with CVA. The criterion for treatment success was marked improvement in at least one primary symptom (e.g., ocular motility difficulty during reading and intermittent diplopia at near) and at least one primary sign (e.g., receded near point of convergence and impaired versional ocular motility). Patients received from 10-30 forty-five minute treatment sessions over a 2-8 month period. Vergence training stimuli included predictable small and large steps and ramps of disparity, as well as sustained disparity levels. Versional training stimuli included predictable horizontal and vertical steps for saccades and ramps for pursuit, as well as visual saccadic scanning and sustained fixation conditions.
90% of those with TBI and 100% of those with CVA were deemed to have treatment success using the present criteria.These improvements remained stable when retested 2-3 months later.
Nearly all patients exhibited either complete or marked reduction in their oculomotor-based symptoms and improvement in related clinical signs, with maintenance of the improvements at the 2-3 month follow-up. These findings demonstrate the efficacy of such clinical oculomotor rehabilitation for a range of eye movement abnormalities in the adult brain-injured population. Furthermore, it demonstrates considerable residual neuroplasticity despite the presence of documented brain damage.
This PDF is available to Subscribers Only