Posts Tagged reading

[BLOG POST] Traumatic Brain Injury- Virtual Reality Technology Used For Vision Therapy

February 12, 2018

So, here is a new subject that hints at hope for traumatic brain injury (TBI) patients. I have previously discussed the role of vision therapy in helping head injury patients, especially those who are having difficulty reading.
Vision therapy is a set of vision exercises and training performed by optometrists with unique equipment in their offices.

Vision therapy certainly has a role in rehabilitation but has numerous obstacles. Number one- patients must make regular appointments for a doctor’s office visit often located some distance from home. Two, only a few optometrist’s perform vision therapy. And third, the cost of therapy is usually not covered by medical insurance.

The future may lie in VIRTUAL REALITY– futuristic-looking goggles and head sets that allow individuals to play 3-D computer games in an immersive environment. The technology keeps improving and costs are coming down.

Forward-looking technology companies are also developing programs for traumatic brain injury (TBI) patients. Only early versions are currently available but the possibility of at-home rehabilitation will soon become a medical reality. All of medicine is moving in this direction.

Reading, depth perception, contrast sensitivity, and peripheral vision disorders can all be explored in virtual reality. The brain and the eye will truly come together in a revolution of new products to aid patients with ocular disease. There are already devices to help people who are blind, but the cost of such devices is considerable. The cost of virtual reality computer goggles and headsets will be coming down in price to sell to the general public- the same techniques that are being explored to develop entertainment are being developed by health companies to treat patients.

In the next year or two, the market will present these devices and an at-home device and therapy to treat TBI victims will be available. In my blog I have explained the many ways head injury can effect eyesight, but there are almost no cures. Cures may be a long way off, but programs to help people read again, reduce double vision, and regain their ability to judge depth are already in the pipeline. I’m not currently an investor in any device, and I will not discuss specific companies, but the research and data is on the internet.

Also, there are already programs you can get on a regular computer screen for vision training and I will discuss these in future blogs. Again, ophthalmologists interested in TBI and related visual disorders can be at a frontier of a whole new branch of ophthalmology. I examine and evaluate TBI patients in my practice everyday and I will keep those who read my blog posted on new information.

Stay tuned!

Steven H. Rauchman, M.D. is an eye physician and surgeon who has been in private practice for 30 years. He has served as an Traumatic Brain Injury (TBI) medical/legal expert for the last 6 years specializing in the area of personal injury and related traumatic brain injuries.


via Traumatic Brain Injury- Virtual Reality Technology Used For Vision Therapy

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[CASE REPORT ARTICLE] The effects of short-lasting anti-saccade training in homonymous hemianopia with and without saccadic adaptation

Homonymous Visual Field Defects (HVFD) are common following stroke and can be highly debilitating for visual perception and higher level cognitive functions such as exploring visual scene or reading a text. Rehabilitation using oculomotor compensatory methods with automatic training over a short duration (~15 days) have been shown as efficient as longer voluntary training methods (>1 month).

Here, we propose to evaluate and compare the effect of an original HVFD rehabilitation method based on a single 15 min voluntary anti-saccades task (AS) toward the blind hemifield, with automatic sensorimotor adaptation to increase AS amplitude. In order to distinguish between adaptation and training effect, fourteen left- or right-HVFD patients were exposed, one month apart, to three training, two isolated AS task (Delayed-shift & No-shift paradigm) and one combined with AS adaptation (Adaptation paradigm). A quality of life questionnaire (NEI-VFQ 25) and functional measurements (reading speed, visual exploration time in pop-out and serial tasks) as well as oculomotor measurements were assessed before and after each training. We could not demonstrate significant adaptation at the group level, but we identified a group of 9 adapted patients.

While AS training itself proved to demonstrate significant functional improvements in the overall patient group , we could also demonstrate in the sub-group of adapted patients and specifically following the adaptation training, an increase of saccade amplitude during the reading task (left-HVFD patients) and the Serial exploration task, and improvement of the visual quality of life. We conclude that short-lasting AS training combined with adaptation could be implemented in rehabilitation methods of cognitive dysfunctions following HVFD. Indeed, both voluntary and automatic processes have shown interesting effects on the control of visually guided saccades in different cognitive tasks.

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[Blog Post] Cognitive Issues





Rebloged from

Broken Brain – Brilliant Mind


Cognitive issues are often the first thing people think of when they think about TBI. After all, it’s your brain, right? And that’s the source of your cognition.

Project LEARNet, which is “A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State”, has some great tutorials on Cognitive and Academic Issues for students after TBI, as well as Self-Regulation/Executive Function Issues. Don’t let the focus on kids / students deter you – these are great resources for anyone who is seeking to better understand TBI.Check out the tutorials on Cognitive and Academic Issues here and Self-Regulation/Executive Function Issues here. They are downloadable PDFs that you can print and take with you – great stuff!

Cognitive Issues after Brain Injury can include:

  1. Altered consciousness
  2. Aura or weird reverie, trance
  3. Trouble concentrating
  4. Trouble making decisions easily
  5. Trouble reading
  6. Analytical skills suffer
  7. Trouble telling what’s real or not
  8. Being easily distracted
  9. Being forgetful, can’t remember
  10. Nightmares
  11. Worrisome thoughts

Source: Cognitive Issues

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In patients with brain damage, often the hemianopic field defect is not diagnosed, because other neurological symptoms, such as hemiplegia, are predominant. The mean time between the brain damage and the diagnosis of the hemianopia was found to be 3 +/- 2 months (Zhang et al 2006). Additionally, the patients oft en do not realize the fi eld defect, even though they experience activity limitations in their everyday life. The classification of the World Health Organizati on (WHO 2004) for Functioning, Disability and Health (ICF) includes three main aspects, which have to be considered in visual impairment:

  1. impairment – related to the organ,
  2. disability or activity limitation – related to the person and
  3. handicap or parti cipati on restriction – related to the society.

Homonymous field defects cause two main disabilities/ activity limitations:

  1. reading disorder, if the central visual field is involved
  2. orientati on disorder (bumping into objects, problems with way finding)…

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Efficacy and feasibility of home-based training for individuals with homonymous visual field defects.

…Home-based compensatory training is an inexpensive accessible rehabilitation option for individuals with HVFDs, which can result in objective benefits in searching and reading, as well as improving quality of life…

μέσω Efficacy and feasibility … [Neurorehabil Neural Repair. 2014 Mar-Apr] – PubMed – NCBI.

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