Vision Rehabilitation is an essential treatment for those experiencing visual difficulties after brain injury, stroke or brain surgery. Congenital problems such as cerebral palsy, downs syndrome and multiple sclerosis can also be helped.

Recent advances in clinical research and therapeutic approaches may assist some patients in improving their visual lifestyles. They may no longer have to live with visual difficulties, such as double vision, or balance problems and can work towards maximum visual capacity. Adaptation to visual field loss, or neglect, may be facilitated by using modern lens forms and treatment. By using vision rehabilitation, other areas such as occupational therapy and physiotherapy can be enhanced.

Two syndromes have been identified related to the need of vision rehabilitation. These are:

Post Trauma Vision Syndrome

Post trauma vision syndrome (PTVS) is a set of symptoms often experienced by a person who has suffered an injury to their brain, whether from an accident, stroke, or even multiple sclerosis or cerebral palsy. These symptoms can be observed at all levels of brain injury, whether mild or severe. Symptoms may include:

• Diplopia (double vision)
• loss of field of vision in varying degrees
• accommodation (focus) dysfunction
• convergence dysfunction
• poor spatial orientation and judgment
• Dizziness or Nausea
• Attention and concentration difficulties
• Staring behaviour
• Problems with reading- such as losing place, or problems with comprehension
• Visual memory problems
• Pulling away from people as they approach

Post trauma vision syndrome has been found to interfere with many aspects of neuromotor and cognitive rehabilitation. In fact, many of the symptoms produced by PTVS have often previously been thought to be a result of psychological problems. The diagnosis and management of all aspects of visual perceptual problems resulting from brain injury is the domain of the behavioural/neuro optometrist. The majority of post trauma vision syndrome cases can be restored to a more appropriate level of visual performance. Treatment may include the use of special lenses, vision therapy or both.

Visual midline shift syndrome is also often associated with brain injury from accident, stroke etc. It occurs when the brain perceived the centre of the body displaced - sometimes to the left or right, or up or down. Often it can be a combination of these. Symptoms may include:

• Dizziness or Nausea
• Spatial Disorientation
• Consistently stepping to one side of hallway or room
• Bumping into objects
• Poor balance/posture - a tendency to learn forward or backwards, or to own side
• when walking, standing or sitting.

It can be relieved with the help of lenses, vision therapy and occupational therapy, and patching.