Rehabilitation
Restoring vision after a brain injury
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Many people who have a stroke or brain injury from tumor or trauma end up with significant vision loss. For example, a stroke on the left side of their body can lead to vision loss in the right half of the vision field. People are left seeing only a portion of what they should be seeing. Everyday activities can become difficult. Reading can be a challenge, and patients sometimes bump into things. Nausea and imbalance can result. For years, patients have received physical and occupational therapies to rebuild their physical skills. There has been nothing to offer them to rebuild vision.
Vision Restoration Therapy is designed for people with vision loss resulting from injury to the brain. It is a computerized therapy that the manufacturers believe allows poorly functioning neurons to be helped by healthy neurons. This idea is called neuroplasticity. Patients are asked to perform about an hour of work daily. They focus their eyes on a specific point displayed on a computer monitor. Dots appear on the screen, and the person clicks the computer mouse to signal when he/she sees them. The computer beeps for positive recognition and makes another noise for ones that are missed. Researchers say the repeated action helps stimulate the neurons.
Patients often don't notice their progress until someone else points out that they are not bumping into items as easily and can now do simple things they once could not do. The manufacturers of the therapy say clinical studies show more than 65 percent of patients have improvement in their vision after completing the initial six months of therapy. Doctors currently believe six months of therapy will work for most patients. They say stopping the treatment will not result in a loss of what was gained. There also is no proven evidence to show therapy longer than six months is beneficial.
There are plenty of skeptics and critics of VRT. Many physicians dispute the idea of it working because of neuroplasticity, where healthy neurons in the brain are actually stimulated to make up for damaged ones. These doctors suggest patients are just learning to move their eyes better, training themselves to scan their visual fields.
Dr. Nancy Newman, a Neuro-Ophthalmologist at Emory University, is offering her patients the therapy. She is not certain of what exactly makes the therapy work but says the important thing is patients are helped. VRT is not currently covered by insurance and costs about $6,000. The therapy is available at six centers in the United States. They include:
- Bascom Palmer Eye Institute, Miami
- Emory Healthcare Eye Center, Atlanta
- Neurological Institute of New York at Columbia University Medical Center, New York
- Clinic of Richard Legge, M.D., Omaha, Neb.
- The Kresge Eye Institute at Wayne State University School of Medicine, Detroit
- University of Miami, Department of Neurology, Miami
Reprinted with permission. Copyright ©2005TWEAN News Channel of Austin, L.P. d.b.a. News 8 Austin