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Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury
Author(s) -
Barton Jason J. S.,
Ranalli Paul J.
Publication year - 2020
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.25820
Subject(s) - traumatic brain injury , physical medicine and rehabilitation , convergence insufficiency , intervention (counseling) , rehabilitation , concussion , psychology , medicine , cognition , fixation (population genetics) , physical therapy , poison control , injury prevention , psychiatry , medical emergency , ophthalmology , population , environmental health
Vision therapy in the form of ocular motor training is increasingly used to treat visual complaints, particularly in the setting of persistent symptoms after mild traumatic brain injury (mTBI). In this review, we discuss the rationale behind this intervention and the evidence for its utility. Although the efficacy of exercises for primary convergence insufficiency is plausible and supported by data, there is not yet strong evidence of benefit for the post‐traumatic variant. It is not established that abnormalities in fixation, pursuit, and saccades in mTBI are the cause of post‐concussive symptoms, or that these abnormalities arise from ocular motor damage rather than being secondary effects of cognitive problems with attention or executive control. The few studies to date have significant methodological weaknesses. More substantial evidence is required before vision therapy can be accepted as a useful tool in the rehabilitation of patients with brain trauma. ANN NEUROL 2020;88:453–461