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Visual problems following an acquired brain injury, such as reading difficulty, visual field loss, and visual perceptual motor deficits, are frequently overlooked or neglected during treatment of the brain injury. This neglect often lengthens and impairs the individual’s rehabilitation which may cause frustration for the individual, family, and treatment team.

Optometric intervention provides an important role in the total rehabilitation effort, allowing affected individuals to perform activities of daily living and improving their quality of life. These are a few suggestions to assist with some of the visual problems:

Reading Difficulties: Many acquired brain injury individuals often experience difficulties in reading..  Jerky eye movements and/or visual field loss make it difficult to keep one’s place while reading. Depending on the specific cause, relief can usually be obtained with appropriate reading glasses, prism lenses/glasses, and vision therapy. Also, by simply moving a ruler down the page, line by line, assists in keeping one’s place when loss of place is caused by jerky eye movements or by a visual field loss.

 Visual Field Loss: Hemianopsia is a condition in which up to one half of the visual field is lost. The affected individual sees little to the left or right of the object they are looking at. This condition makes driving hazardous; and individuals bump into walls, doorways, and knock over items such as cups and glasses. An individual would benefit by utilizing eye movement strategies and exercises to look into the lost field to see what is there. There are numerous computer software programs available for visual impairments.

Visual Perceptual Motor Deficits: Individuals with acquired brain injury frequently experience:

  • unstable orientation in space so that objects, even walls and floors, are perceived to move and shift about
  • difficulty with object localization and visual judgments in space
  • inability to sustain visual attention and have poor visual memory

These functions are often improved by:

  • wearing prism lenses/glasses to restore one’s ability to orient the individual in space
  • neuro rehabilitative therapy to improve visual perceptual spatial and information processing functions

Optometric rehabilitation provides an important role in the overall rehabilitation effort, along with individualized treatment regimens
and therapy procedures to relieve symptoms and increase vision efficiency.

I offer my sincere thanks to Don Fong, O.D., and Carl Garbus, O.D., who presented this still relevant information at a conference many years ago.

To obtain further resources and information, we recommend visiting The Neuro-Optometric Rehabilitation Association, International (NORA) website,