Efficacy of Neuro-Optometric visual rehabilitation in Homonymous Hemianopia

ABSTRACT

Objectives

To assess oculomotor dysfunction and the effectiveness of neuro-optometric visual rehabilitation in improving oculomotor parameters in participants with homonymous hemianopia.

Materials and Methods

Fifty subjects diagnosed with homonymous hemianopia (HH), referred through the neuro-ophthalmology department, were recruited for the study. All the subjects underwent a detailed neuro-optometric evaluation that included testing for sensory, visuo-motor and oculomotor functions. Subjects with homonymous hemianopia were then prescribed with yoked prisms and were randomized to two treatments at one month, namely group 1: yoked prisms (n = 15) and group 2: yoked prisms with in-office visual search training (n = 15).

Results

The mean ± SD age of the subjects was 46 ± 12 years. Subjects with HH exhibited a significant delay in the completion time, response and accuracy of tasks on proactive, saccadic and visual search parameters using the SVI compared to age-matched controls (Independent t-test, p < 0.05). A significant improvement in the reading speed and visual search parameters (RM ANOVA, p < 0.001) was seen post neuro-optometric visual rehabilitation with both yoked prisms and SVI. Statistically significant differences were observed in the reaction time of the visual search paradigms between the two rehabilitative modalities yoked (group1), yoked and SVI (group2) (Mann-Whitney U test, p < 0.001), with the group 2 showing better visual search performance outcomes compared to group 1 (yoked).

Conclusion

Visual search parameters among participants with homonymous hemianopia improved following combined rehabilitation (yoked prisms and visual search trainng).

KEYWORDS:

• Homonymous Hemianopia
• reading
• eye movements
• reaction time
• rehabilitation

Acknowledgments

Dr. Shikka Bassi, Dr. Smita Praveen, Dr. Durga Priyadarshini S, Dr. Vidhya Dharani D M, Dr. Padmalakshmi K - Department of Neuro-Ophthalmology, Sankara Nethralaya to refer patients for this study and Aishwarya Ravi, Student, Sankara Nethralaya, for being a part in my thesis. This study was presented as oral presentation two scientific conferences namely 18^th Dr. E Vaithilingam Memorial Scientific Session and Symposium in Neuro Ophthalmology: Afferent Plus Efferents.

Disclosure statement

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

Authorship

1. Conception and design: Jameel Rizwana Hussaindeen, Nayan Gupta, Ayisha Atiya, and Ambika S

2. Drafting the manuscript: Nayan Gupta, Ayisha Atiya, Jameel Rizwana Hussaindeen and Ambika S

3. Final Approval of the version published: Jameel Rizwana Hussaindeen, Nayan Gupta, Ayisha Atiya and Ambika S

4. Agreed to be accountable for all aspects of work: Nayan Gupta, Jameel Rizwana Hussaindeen, Ayisha Atiya, and Ambika S

Supplementary Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2024.2309254

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit organisations.