Concussion / Traumatic Brain Injury Service in Toronto, ON
Note: This service is only provided at the Downtown Toronto Bay Street Eyecare location.
Click here for the Neuro Optometric Assessment (NOA) Form . (The form must be completed prior to the appointment and brought to the visit.)
Vision symptoms are very common following a concussion/brain injury, and can include:
- Discomfort, eyestrain, or blur while reading or doing computer tasks
- Light sensitivity
- Motion sensitivity
- Avoidance of crowded places such as grocery and department stores
- Double vision
- Balance issues and dizziness
These symptoms are not typically addressed with a standard comprehensive eye examination and require a specialized assessment. Visual dysfunction is typically not visible with CT/MRI scans. A neuro-optometric exam focuses on brain functions, such as sensory, motor, and information processing, as well as perception of where one is in space and where objects are in relation to the person. Visual processing dysfunction is not addressed or tested during standard visual acuity or eye health testing. In fact, it is very possible to test an acuity level of 20/20 without a glasses prescription and yet the patient presents with severe visual impairment!
Eye Care Treatment After A Concussion
Treatment strategies include glasses with specialized lenses and customized coloured tints to stabilize the disrupted visual system, as well as vision therapy to rehabilitate visual skills affected by the injury. Come Visit Dr. Blanc at one of her Mid-Town Toronto location or if you work Downtown near the Financial District.
What Is Post Concussion Rehabilitation?
A Vision Rehabilitation Program involves a co-ordinated and integrated series of visual tasks designed to produce more cognitive awareness as a means of improving eye movement control, enhanced accommodative and binocular function, finer stereopsis, and most importantly, improved overall spatial function. It is designed to correct spatial misperception, enhance spatial localization, and develop more accurate spatial maps. One must have the visual-spatial understanding of where to point and focus the eyes in space to most effectively perform the mechanics of the task (The goal is not to "strengthen the eye muscles").
Therapy can range from weekly (ideal according to literature) to monthly in-clinic sessions, with daily assigned home activities which are regularly adjusted. Therapy duration varies depending on the case, however it is not unusual for a vision rehabilitation program to be implemented for 12 months. Treated patients typically report decreased light sensitivity, enhanced visual performance including reading comfort and speed, less anxiety about navigation, and reduction or elimination of eyestrain and headaches.
Vision stabilization and rehabilitation sets the stage for more effective therapy with physiotherapists and occupational therapists. Treatment of brain injury is a coordinated multi-disciplinary effort utilizing the specialized expertise of each team member, including occupational therapists, physical therapists, and physicians. Vision rehabilitation can be a valuable component of this collaboration. Dr. Blanc is an advocate of regular communication with the medical team.
Sanet Vision Integrator
This is an interactive neuro-optometric in-office computer program that trains the visual system including:
- Speed and accuracy of eye tracking and rapid changes in fixation
- Sustained visual attention
- Eye-hand co-ordination
- Integration of central and peripheral vision
- Customized peripheral target locations for patients with peripheral vision loss
- Visual and auditory sequencing, memory, and integration
- Automaticity of number, letter, and word naming
- Auditory and visual feedback with respect to balance while performing program tasks
What To Expect During Your Visit To Our Eye Doctor in Toronto?
Dr. Shirley Blanc is a Toronto based optometrist with background and training in vision rehabilitation of traumatic brain injury. Evaluation includes 2 parts on separate days:
1) Full eye exam: visual acuity, vision prescription check, general eye alignment testing and thorough eye health assessment.
2) Neuro-Optometric exam: fixation, tracking/scanning, eye alignment and focusing flexibility and stamina, peripheral vision analysis, visual-spatial, perceptual, and visual-motor deficits directly affected by the injury.
Supplementary insurance may cover a portion of glasses, assessments, or vision therapy. This is not an OHIP covered service.