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Vision Therapy

Brain Injury (Strokes, Trauma)

The visual system is often adversely affected when the brain is injured by trauma (e.g. auto accidents), stroke, or brain tumors. Since eighty percent of the information we receive about our environment is from the visual system, vision problems significantly impair a patient’s functioning. This is also known as Post Traumatic Vision Syndrome.

eye exam Clarks Summit PAYou need to see correctly to function correctly because the eyes guide the hands and body. Many brain injury patients feel spatially disoriented because they are either missing part of their visual field, or because their depth perception is altered. Until recently, patients suffering from vision impairments related to brain injury were told that there was no treatment available. A new field called Neuro-Optometric Rehabilitation can help brain injury patients regain as much functional vision as neurologically possible.

Patients who suffer from brain injury such as strokes, tumors or head trauma, neurosurgery, or aneurysm often sustain long-term functional deficits. These deficits include difficulty talking (aphasia), walking, poor fine motor control, and diminished cognitive abilities.

Visual skills, vision after strokes (or other types of brain injuries by trauma), and activities dependent on visual information can also be profoundly affected, because vision guides movement. When visual skills such as tracking, focusing and depth perception are impaired, this interferes with daily activities such as reading, driving, reaching, writing, eating, or walking down stairs.

Symptoms of brain injury-related visual impairment include:

  • double vision
  • poor judgment of distance while driving or reaching for objects
  • difficulty judging the depth of stairs or curbs
  • the floor appears to tilt downwards, or upwards
  • frequent loss of place while reading
  • skipping words
  • sensitivity to light
  • vertigo
  • fluctuating vision
  • bumping into objects
  • decreased depth perception
  • leaning to one side
  • eyestrain with prolonged visual tasks
  • head tilt or head turn
  • visual spatial disorientation

Visual Rehabilitation After Brain Injury

Vision Therapy is the treatment for these visual motor and visual perceptual defects. Impaired visual skills need to be re-learned through exercises the same that way large motor skills, such as walking, are re-trained through physical and occupational therapy. Through Visual Rehabilitation, a patient can be trained to use his or her eyes correctly again. This gives hope to the thousands of brain injury patients who are desperately looking for ways to regain their independence and quality of life.

Dr. Domiano evaluates patients to determine how their vision was affected after a stroke or brain injury, and prescribes a variety of treatments to help improve their vision. One such treatment involves the use of special glasses, called prisms, to help expand a patient’s peripheral vision if they have a hemianopsia (reduced side vision). She also works with the patients’ occupational and physical therapists to help the patient relearn sufficient visual skills to drive safely again. Visual skills are important for stopping correctly at a stop light, staying in the middle of a lane, changing lanes, and avoiding obstacles on the road.

Since 80% of the information that we receive about our environment is through the visual system, it is paramount that impaired visual skills are identified early and re-trained. This helps the overall rehabilitation process by maximizing motor and daily activities that are dependent on visual skills.

For more information, please refer to the website for the Neuro Optometric Rehabilitation Association at:

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