In my opinion, recovery from a TBI is difficult, but getting a proper diagnosis is even harder. I have spent 8 months since my injury trying to figure out what happened and why I experienced so many symptoms. It was not until my Neuro-Optometrist that gave me hope not only in a path towards healing, but a solid explanation and diagnosis of my injury. And, that matters.
In the realm of healthcare, certain specialists possess a unique blend of expertise that traverses traditional boundaries. Enter the Neuro-Optometrist, a professional pivotal in linking the intricate relationship between vision and brain health. In this blog post, I'll delve into the realm of Neuro-Optometry, exploring their multifaceted role, specialized tests for brain trauma, and two innovative therapies revolutionizing patient care.
First, I truly lucked out when I was referred to a Neuro-Optometrist. After being reviewed by an Ophthalmologist and a regular Optometrist and being told that my pupillary reactivity that my Occupational Therapist noted during her assessment was "normal abnormal", I continued to question their assessments and sought to search for more answers with specialists who could better assess me. The only symptom that was medically being witnessed was my pupils and I was not going to sit idly and not investigate further. Thus, enter my referral to a Neuro-Optometrist from my regular optometrist who noted that she could not tell if anything was wrong, but her "super smart, higher pay-grade friend" could. And to give my regular Optometrist even more credit, she did assess that while my vision did not change since I saw her last something drastic did and that was my convergence and accommodation (basically my eyes ability to work together and bring an object into view) and she mentioned that something like this does not normally progress this quickly unless I was injured. Ah, finally. I had a doctor hone in on my symptoms and wanted to help in any way that she could help.
Understanding the Role of a Neuro-Optometrist:
Neuro-Optometrists are optometric professionals with advanced training in evaluating and managing visual conditions associated with neurological issues. Unlike conventional optometrists who primarily focus on refractive errors and eye health, Neuro-Optometrists delve deeper into how the brain processes visual information.
Their expertise extends to diagnosing and treating various conditions such as traumatic brain injuries (TBI), concussions, stroke-related vision problems, and neurological disorders like multiple sclerosis and Parkinson's disease. By understanding the complex interplay between the eyes and the brain, Neuro-Optometrists play a pivotal role in optimizing visual function and enhancing overall quality of life for their patients.
Specialized Tests for Brain Trauma:
In cases of brain trauma, accurate assessment is paramount for effective management and rehabilitation. Neuro-Optometrists employ a battery of specialized tests to evaluate visual function and detect subtle abnormalities indicative of underlying neurological issues. In my case, I went into the office three separate times for about two hours of testing each time and I received an 11-page document on what they tested, where I fell short, and what symptoms could result from these shortfalls.
Some of these tests include:
Visual Field Testing: This evaluates the full extent of a person's peripheral vision, which can be compromised following brain trauma. By mapping out any visual field deficits, Neuro-Optometrists can assess the integrity of the visual pathways within the brain.
Ocular Motility Examination: This assesses the coordination and smoothness of eye movements, which can be impaired in conditions such as concussion or brainstem injury. Abnormalities in ocular motility can provide valuable insights into the functioning of specific brain regions responsible for eye movement control.
Binocular Vision Assessment: By examining how both eyes work together as a team, Neuro-Optometrists can identify issues such as convergence insufficiency or binocular vision dysfunction, which are common sequelae of traumatic brain injuries.
For me, I was shocked by the report. It not only linked my symptoms to actual facts, but it also provided a summary that after 8 months of advocating with little to no doctor-support, I needed to see. l can't describe just how crazy I felt visiting doctor after doctor only to hear "there is no way TMS could injure you" or "you have to have an underlying condition" or even, "you have nothing physically wrong with you, you just had a headache." The assessment from the Neuro-Optometrist put real concrete testing to my symptoms - and to be honest, I thought I was acing everything which not only demonstrates my complete lack of personal assessment at the time, but also that I had no idea what outcome I should have achieved.
My Visual Skill Diagnosis:
Deficient Smooth Pursuit of Eye Movement
Deficient Saccadic Eye Movements
Convergence Insufficiency
Fusion with Defective Stereopsis
Diplopia
Dizziness
My Visual Assessment Conclusion:
Jordan's reported symptoms are consistent with the visual examination findings and are common in individuals who sustain a mild traumatic brain injury.
It is significantly more difficult for an individual with Jordan's cluster of dysfunction to perform visual tasks with the ease and stamina of a person with normal vision function. The visual dysfunctions will seriously compromise Jordan's ability to work, drive, and manage normal activities of daily living such as bill paying, grocery shopping, or project management.
With Jordan's cluster of visual dysfunctions, attempting to perform reading, writing, computer, and other visual tasks commonly results in symptoms of visual and general fatigue, visual and physiological stress, psychological stress, headache, and difficulties with concentration and memory.
I (the Neuro-Optometrist) believe it may be possible for Jordan to recover some, if not all, of her visual abilities, and greatly reduce her resultant symptoms with proper therapy and work accommodations.
Jordan needs to be in a work and home environment that does not elicit the visual stress which triggers the resultant symptoms.
Innovative Therapies in Neuro-Optometry:
In addition to diagnostic assessments, Neuro-Optometrists employ cutting-edge therapies aimed at restoring visual function and facilitating neurological recovery. Two such therapies gaining traction are:
Trauma Glasses: Designed to mitigate the visual symptoms associated with brain trauma, trauma glasses incorporate specialized tints, prisms, and lens designs tailored to the individual's unique visual needs. These glasses help alleviate symptoms like light sensitivity, visual distortions, and difficulty with reading or focusing, thereby improving comfort and visual clarity.
Light Therapy: Light therapy, also known as phototherapy or vision therapy, involves the strategic use of specific wavelengths of light to stimulate neuronal activity and promote neuroplasticity within the visual pathways. By exposing patients to targeted light sources, Neuro-Optometrists can enhance visual processing speed, improve contrast sensitivity, and alleviate symptoms of visual fatigue or photophobia.
In my case, I was given both trauma glasses and light therapy to heal. I am currently wearing my trauma glasses and was told that as my eyes change, I might need to get a new prescription every couple of months for the next 6 months to a year until my eyes settle. It most likely will be a different prescription than my prescription before my brain injury.
Light therapy, however, was a 6-week journey where I was given a protocol to slowly build to 20-minutes a day with a specific set of parameters. I was using three different wavelengths - purple, blue, and teal. As I learned more about the color-spectrum, the blue and purple were for the visual issues that I struggled with like convergence insufficiency, and the teal was about detoxing. Also, all three of these colors are linked to the Parasympathetic Nervous System which needed to be stimulated since my brain was in fight-or-flight.
Why They Work:
Trauma glasses work by selectively filtering out certain wavelengths of light that exacerbate visual discomfort and sensory overload in individuals with brain trauma. By customizing the tint and intensity of the lenses, Neuro-Optometrists can optimize visual comfort and enhance contrast sensitivity, allowing patients to navigate their environment with greater ease.
Light therapy harnesses the neuroregenerative properties of light to stimulate synaptic connections and facilitate neural repair within the damaged visual pathways. By modulating the activity of retinal ganglion cells and cortical neurons, light therapy promotes adaptive changes in visual processing, leading to improvements in visual acuity, spatial awareness, and overall visual function.
In conclusion, Neuro-Optometrists occupy a vital niche within the healthcare landscape, bridging the gap between vision and brain health. Through their specialized expertise, comprehensive testing protocols, and innovative therapeutic interventions, they offer hope and healing to individuals grappling with the aftermath of brain trauma. As we continue to unravel the complexities of the human brain, the role of Neuro-Optometry in optimizing visual and neurological outcomes remains ever-essential.
In the journey of healing after a brain injury, seeking the expertise of a neuro-optometrist becomes paramount. Addressing conditions like convergence insufficiency, light sensitivity, noise sensitivity, tracking difficulties, and impaired pupil reactivity requires specialized care that goes beyond traditional optometry. In the case like mine or anyone else recovering from a brain injury with impairments linking to their visual nerves, a neuro-optometrist possesses the knowledge and tools to assess and treat these complex visual disturbances, working hand-in-hand with other healthcare professionals to optimize your recovery. By addressing the intricate connection between the brain and vision, a neuro-optometrist offers personalized interventions that can significantly improve your quality of life and facilitate your journey towards healing and rehabilitation.
All my light. All my love.
Namaste,
Jordan
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