Authors
Conrad, Joseph Samuel; Mitchell, G. Lynn; Kulp, Marjean Taylor

Vision Therapy for Binocular Dysfunction Post Brain Injury

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Abstract/Introduction

Purpose 

To prospectively evaluate the effectiveness of home-based computer vergence therapy for the treatment of binocular vision disorders in adults at least 3 months after an acquired brain injury.

Methods 

Eligibility criteria included presence of binocular dysfunction characterized by receded near point of convergence (≥6 cm break), insufficient positive fusional vergence at near (failing Sheard’s criterion or <15△ blur or break), insufficient negative fusional vergence at near (<12△ blur or break), and/or reduced vergence facility at near (<15 cycles per minute with 12△BO/3△BI). Participants were prescribed 12 weeks of home-based computer vergence therapy. Phoria (cover test), negative fusional vergence, positive fusional vergence, near point of convergence, vergence facility, and symptoms (convergence insufficiency symptom survey [CISS]) were assessed at baseline and after 4, 8, and 12 weeks of prescribed therapy. ANOVA was used to evaluate change in each measure. Percentage successful was also determined.


Conclusion/Results

Results 

Nineteen participants were enrolled (mean age 45.4 ± 12.9 years); six participants were lost to follow-up. Baseline findings were orthophoria at distance, 7.2△ exophoria at near, near point of convergence break = 17.5 cm, near point of convergence recovery = 21.8 cm, negative fusional vergence = 12.3△, positive fusional vergence blur = 8.4△, vergence facility = 3.9 cycles per minute, and CISS = 32.1. ANOVA showed a statistically significant improvement for near point of convergence break (p = 0.002) and recovery (p < 0.001), positive fusional vergence blur (p < 0.0001), break (p < 0.0001), and recovery (p < 0.0001), negative fusional vergence blur (p = 0.037), break (p = 0.003), and recovery (p = 0.006), vergence facility (p < 0.0001), and CISS (p = 0.0001). The percentage of patients who were classified as “successful” or “improved” was 69% for near point of convergence (<6 cm or decrease of ≥4 cm), 77% for positive fusional vergence (>15△ and passing Sheard’s criterion or increase of ≥10△), 77% for negative fusional vergence (≥12△ or increase of ≥6△), 62% for positive fusional vergence and near point of convergence composite, and 92% for vergence facility (15 cycles per minute or increase of 3 cycles per minute).

Conclusions 

The majority of participants who completed the study experienced meaningful improvements in signs and symptoms.


Testimonials


  • I haven't actually used the optometrist side, so my review is limited to the vision therapy offered.  This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.


    Claire A.

  • Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.


    Jim K.

  • My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy.  She (Chris) is absolutely great.  I am impressed with the array of tools used to help recover my binocular vision.  I am doing things I never thought were possible (balance boards etc).  Chris pushes me and keeps me motivated. I really enjoy my sessions with her.  The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!


    Teresa S.

  • The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.


    Joe M.

  • I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.


    Kayla W.

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