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2018 AOA TBI Panel

Concussion/Traumatic Brain Injury Panel

Part 2: Vision Assessment after Brain Injury

AOA TBI Part2 Simonson LECTURE SLIDES

Visual problems resulting from Traumatic Brain Injury (TBI)

and

Clinical chair-side pearls when working with Post-Concussion Vision Syndrome

Additional Resources:

  1. OCULOMOTOR
    1. VOMS: Vestibular Oculo-motor ScreenSource: Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman-Enseki C, DeWolf RM, Marchetti G, Kontos AP. A brief vestibular andocular motor screening(VOMS) assessment to evaluate preliminary concussion: Preliminary findings. Am J Sports Med; in press.
      Form Sources: https://www.bamc.org/media/1393/voms-exam.pdf
      https://www.physiotherapyalberta.ca/files/vomstool.pdf
      VOMS Instruction Set
      https://www.youtube.com/watch?v=PJLv5zdmEns
    2. The King-Devick Test: https://kingdevicktest.com/
    3. NSUCO Oculomotor Test
      NSUCO-Oculomotor-Test Instruction Set
      Norms for Oculomotor Skills: Pursuits and Saccades: https://www.oepf.org/sites/default/files/journals/jbo-volume-3-issue-6/3-6%20Maples.pdf
  2. PERIPHERAL VISION
    1. Tests for Neglect/Unilateral Spatial Inattention: https://www.strokengine.ca
    2. amsler-grid
  3. PERCEPTION: VISUAL/VESTIBULAR
    1. Visual Vertigo
    2. Balance Error Scoring System manual
    3. BIVSS Symptom Assessment: BIVSS_clinical
      Brain_Injury_Vision_Symptom_Survey__BIVSS_.98478_08.2016
    4. http://www.braininjuries.org/traumatic_brain_injury.html
  4. BINOCULAR (Sensory Fusion/Motor Alignment)
    1. Worth 4 Dot W4D results
    2. Bagolini Lens Bagolini Test Responses
  5. VISION REHABILITATION
    1. Neuro-optometric Rehabilitation Association: https://noravisionrehab.com/
    2. Vision Training can decrease concussions: http://healthnews.uc.edu/news/?%2F26057%2F

Courses for additional training:

Neuro-optometric Rehabilitation Association: https://noravisionrehab.com/clinical-skills/fellowship-program

The College of Optometrists in Vision Developoment: https://www.covd.org/page/braininjury?

The Optometric Extension Program Foundation: http://oepf.org/education

REFERENCES:

Research supporting vision rehabilitation following head injury:

1.Vision Therapy for Post-Concussion Vision Disorders. Gallaway, M, et al. Optometry & Vision Science: Jan 2017 – Vol 94 – Issue 1 – p. 68-73 .

2.A Review of the Current Practice in Diagnosis and Management of Visual Complaints Associated with Concussion and Postconcussion Syndrome. Heinmiller, L and Gunton, K. Curr Opin Ophthalmol 2016; 27(5): 407-412.

3.Current and Emerging Rehabilitation for Concussion: A Review of the Evidence. Broglio, S, et al. Clin Sports Med 2015 April; 34 (2): 213-231.

4.Concurrent Vision Dysfunctions in Convergence Insufficiency with Traumatic Brain Injury. Alvarez, T, et al. Optom Vis Sci. 2012 December: 89 (12)

5.Website (retrieved 2/7/2017) http://casemed.case.edu/clerkships/neurology/NeurLrngObjectives/Vision.htm

6.Review of Optometry, “Save a Life, Neuro-Optometry Primer: The Brain” by Mario Gutierrez, OD, FAAO. https://www.reviewofoptometry.com/CMSDocuments/2009/9/Neuro-Optom-Supp_RO-09.02.09.pdf

7.http://cpdailyliving.com/cortical-visual-impairment-cvi-cerebral-palsy-underdiagnosed-undertreated/

8.http://www.perkinselearning.org/videos/webcast/cortical-visual-impairment-and-evaluation-functional-vision

9.http://www.visiontherapysuccess.com/headtrauma.php

ADDITIONAL INFORMATION:

What did not fit into the alloted time?

Videonystagmography

  1. Ocular Mobility: the eyes follow objects that jump from place to place, stand still, or move smoothly.
  2. Optokinetic Nystagmus: view a large, continuously moving visual image.
  3. Positional Nystagmus: You will have your head and body moved into various positions to make sure that there are no inappropriate eye movements (nystagmus), when your head is in different positions. This test is looking at your inner ear system.
  4. Caloric Testing: Your inner ears (one at a time) with be stimmulated with warm and then cold air. This test in the only test available that can decipher between a unilateral and bilateral loss.

*Please let Dr. Simonson know if there is information that we discussed not included on this page. Thank you for attending this course!

Sanet Seminars in 2016

Please note that Dr. Simonson will be out of the office to attend the 2016 Sanet Seminars:

January 8-10
March 4-6
May 13-15
July 15-17
September 9-11

Additional information

January 2016:

Visit to the Center for Vision Care in Lemon Grove

Visit to the Center for Vision Care in Lemon Grove

20160108_191233

Dr. Brenda training on color ring toss during a visit to Dr. Hilliar’s office.

20160108_192248

Colleen is sharing therapy techniques about visual-tactile integration.

Dr. Hilliar training us on Color Stix at his practice.

Dr. Hilliar training us on Color Stix at his practice.

20160108_202336

Dr. Simonson visiting Old Town San Diego

20160108_220949

Colorado attendees: Dr. Amy and Cindy in Old Town San Diego

Colorado attendees: Cindy, Dr. Jen and Dr. Brenda

Colorado attendees: Cindy, Dr. Jen and Dr. Brenda

Colorado Vision Training Conference Links

Primitive Reflexes and Sports Vision: Visual Foundations to Peak Performance

1. http://sensoryfocus.com/ The Vision Development Team website

2. Institute for Neuro-Physiological Psychology “INPP”: http://inpptrainingusa.com/

Sally Goddard Blythe: http://sallygoddardblythe.co.uk/

3. The listening Program “TLP” – http://www.advancedbrain.com/

4. Integrated Listening Systems “ILS” – http://integratedlistening.com/

5. Masgutova Neurosensorimotor Reflex Integration “MNRI” – http://masgutovamethod.com/

6. The Relationship Between Retained Primitive Reflexes and Visual Skill Deficit:

https://prezi.com/barzsnxwd2ys/the-relationship-between-retained-primitive-reflexes-and-vis/

CVTC2015b2

Day 2:

7. Tripp Trapp Chair: https://www.stokke.com/USA/en-us/highchairs/tripp-trapp/1444.html

8. Agility Ladder: http://www.dickssportinggoods.com/product/index.jsp?productId=10919576

Lots of great videos on you tube, example: https://www.youtube.com/watch?v=qhPN7B9bisU

9. Romberg Balance Testing:

http://geriatrictoolkit.missouri.edu/Agrawal-Romberg-EC-compliant-norms-2011.pdf

We observed that the time to failure decreased with increasing age across all sex and race/ethnicity categories. We found that once individuals went below a time to failure of 20 seconds, there was a significant greater than 3-fold increase in the odds of falling. In general, participants crossed the 20-second threshold at the age of 60 to 69 years.

10. One foot balance:

Age 3 – 2 seconds
Age 4 – 4-8 seconds
Age 5 – 8 seconds either foot
Age 6 – 20 seconds
Age 8 – 30 seconds

Pediatric Balance Scale

Adult Norms for one-leg standing balance:

http://geriatrictoolkit.missouri.edu/balance/Normative_Values_for_the_Unipedal_Stance_Test_Springer-JGPT.pdf

http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=1150

11. The Ghost in my Brain by Clark Elliot

Ghost in my Brain

12. Reflex Screening Form

13. Reflex List

14. Stopping ADHD by O’Dell and Cook

Stopping ADHD

15. Oculo-Head Righting Reflex and Labyrinthine Head Righting Reflex example:

You-tube Chicken video: Chicken Head

16. Emotional Freedom Technique

EFT

17. Brain Dance Video example: https://www.youtube.com/watch?v=r7WA333jqAI

18. Emergent VT: https://www.youtube.com/watch?v=r7WA333jqAI

19. Fat Cat Vision therapy (perception): http://fatcatvisiontherapy.com/

20. No Drama Discipline

2014 08 04 NoDrama HC nospine thumb

21. Color-lined paper: http://shoponline.pfot.com/product633.html

smartwritingpaper

22. Handwriting without Tears Program

23. Gemiini Speech Program: https://gemiini.org/

Brock String with Hula Hoop:

20150919 152657

Micro Brock String:

20150919 163452

Thanks for a GREAT Day!!

IMG 1030

Day 3:

24. Reflex Integration Program Review

25. Reflex Integration Advancement

26. Reflex Program Levels

2015 Neuro-Optometric Rehabilitation Association Annual Meeting

The Neuro-Optometric Rehabilitation Association, International (NORA) is a group of committed individuals from various disciplines focused on advancing the art and science of rehabilitation for the neurologically challenged patient. Neuro-Optometric Rehabilitation is an individualized treatment regimen for patients with visual deficits as a result of physical disabilities, traumatic brain injuries, stroke, and other neurological problems. It specifically treats acquired visual dysfunctions as determined by standardized diagnostic criteria and should be a part of the multi-disciplinary rehabilitation team. The treatment regimens encompass medically necessary compensatory and non-compensatory lenses and prisms with or without occlusion and other appropriate strategies.
This conference will demonstrate the importance of neuro-optometry and its role in effectively collaborating with the rehabilitation team in improving patient outcomes.

College of Optometrists in Vision Development

COVD 39th Annual Meeting
October 13-17, 2009
Denver Marriott Tech Center
Denver, Colorado

Our staff will be completing a 2 year certification process at this year’s annual meeting. Two thousand hours of experience are required before seeking certification. Our therapists have written and submitted papers on such topics as strabismus, amblyopia, focusing disorders, tracking skills, eye teaming ability, and therapeutic techniques. All papers were accepted earlier in 2009. All therapists have also completed a proctored written examination on their vision therapy knowledge. On October 13th, Amy, Barbara, Gail and Krystal will take their oral exams. Keep them in your thoughts! We have been completing 2 hours of additional training every Monday since November 2008 in preparation for this milestone.