Vision therapy improves binocular visual dysfunction in patients with mild traumatic brain injury

ABSTRACT

Objective

To evaluate benefits of binocular vision and ocular motility training in patients with long-term sequelae after mild traumatic brain injury (mTBI).

Methods

Twenty-eight mTBI (concussion) patients from 25 to 61 years of age with oculomotor dysfunction were selected by optometric examination. The vision therapy was designed to improve convergence, pursuit and saccades as well as to increase fusional reserves. The vision therapy was conducted by a neurooptometrist and a speech therapist, and took place weekly for 1 hour during 10 continuous weeks. Between vision training sessions, patients trained at home for 15–20 minutes daily. Before and after vision therapy, patients completed a test battery including the Groffman Visual Tracing Test, King-Devick test (K-D), a reading speed test, Multidimensional Fatigue Inventory (MFI-20) and patient interviews based on a modified version of the Canadian Occupational Performance Measure (COPM).

Results

Twenty-seven patients completed the vision therapy. After the therapy, improvements were measured on all test parameters, e.g. Groffman Visual Tracing Test (p < 0.05), K-D-Test (p = 0.01), Reading Speed Test (p < 0.01) and MFI-20 total (p < 0.05). The results for the modified COPM were significantly improved for both performance and satisfaction (0.0001 < p < 0.01).

Conclusion

Vision therapy improved fixation stability and endurance. Reading speed measured by the numbers of saccades and regressions time consumption per read word increased. There was also an improvement in visual attention, possibly making patients safer in traffic and outdoor activities.

KEYWORDS:

• Commotio
• vision therapy
• oculomotor dysfunction
• convergence insufficiency

Acknowledgments

The study was supported by the Center for Special Education (CSU), Slagelse, Denmark. Also we would like to thank senior lecturer at the Danish College of Optometry and Vision Science, Ivan Nisted, for his valuable comments for the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The study has been supported by the Center for Special Education (CSU), Slagelse, Denmark.

Notes on contributors

Peter Smaakjær

Peter Smaakjær (Born 1960) is a Danish optometrist and neuro-optometrist, and has a Master degree clinical optometry. Currently work with low vision, stroke and commotion patients.

Lone Grønnegaard Wachner

Lone Grønnegaard Wachner (Born 1956) is a Danish speech and language pathologist. Wachner is currently working with rehabilitation of stroke and commotio patients.

Rune Skovgaard Rasmussen

Rune Skovgaard Rasmussen (born 1973) is a Danish neuropsychologist and associate professor of general pathology, and has a Ph.D. in neuroscience (stroke research). Rasmussen has participated in stroke research since 1998.