Visual Rehabilitation Using the Luebeck Software in Patients With Homonymous Hemianopia

Abstract

Purpose:: To study visual rehabilitation in homonymous hemianopic patients using the Luebeck Rehabilitation Program and determine its ability to increase quality of life in this patient sample.

Methods:: Three subjects with left homonymous hemianopia (two secondary to stroke and one to trauma) were studied. Each subject was given a complete ophthalmologic exam including Amsler grid testing and Goldman perimetry prior to and after vision training on the computer using the Luebeck Rehabilitation Program. In addition eye tracking to determine saccadic movements was performed on each subject before and after training using campimetric passage-based and tracking stimuli. The visual rehabilitation program entailed 100 treatment trials on the computer. Results of the studies performed before and after were analyzed to determine changes in visual fields and also the ability to partake in daily tasks of living such as reading.

Results:: For patient one (female after stroke), she demonstrated an increase in visual fields of ten degrees into the missing field on both Amsler grid testing and Goldman perimetry. Visual rehabilitation in this patient resulted in her regaining the ability to read which she was unable to do prior to vision training. For patient two (male after stroke), there was an increase in visual field in both eyes of two degrees off both the vertical and horizontal meridians. Eye tracking revealed slight fluctuation in the frequency of saccadic movements over time before and after treatment. He demonstrated an improved ability to walk as obstacles on his left side were noted earlier, preventing him from injuring himself. For patient three (male after motor vehicle trauma), there was an increase in visual field of three degrees off the vertical meridian in the left eye on Amsler grid testing. Eye tracking also showed stable saccade frequency before and after treatment. He demonstrated an improved ability to read more comfortably.

Conclusions:: Visual rehabilitation in patients with homonymous hemianopia does improve in each patient with varying results after a set of trials of the Luebeck Rehabilitation Program while eye tracking showed slight fluctuation in saccadic frequency. Most importantly, quality of life improved in these patients after training, allowing them to regain some of the activities performed prior to loss of vision.

Keywords: neuro-ophthalmology: cortical function/rehabilitation • visual fields