NSW Brain Injury Rehabilitation Forum May 2011

 

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Orthoptic treatment options for visual problem
found in brain injured clients
LIANE WILCOX, Eyetreat, Castle Hill

 

Title: Orthoptic treatment options for visual problems found in brain injured clients

Author: Liane Wilcox DOBA, M.App.Sc. (Orthoptics), Eyetreat, Castle Hill, Sydney; Discipline of Orthoptics, Faculty of Health Sciences, University of Sydney

Assessment of the visual function of a brain injured patient by an orthoptist has occurred in the Brain Injury unit at Westmead Hospital since 1985 in one form or another. The orthoptist, often working in conjunction with an ophthalmologist can assess a client's visual function and inform other therapists on how the visual problems found can best be dealt. However, limited resources within the hospital framework limit the availability of visual rehabilitation by an orthoptist and as such this type of treatment has previously been out of reach for many clients.

Orthoptic treatment by visual rehabilitation techniques has been performed on brain injured clients using evidence based treatments to many clients under the private practice model as well as through non-government agencies. This type of treatment is often outside the range of traditional orthoptic treatments and requires the orthoptist to have a special interest in the area of brain injury and stroke, similar as to what occurs in the other therapies such as OT, speech and physiotherapy.

The main visual areas where visual rehabilitation as been shown to improve visual function and be of benefit in improving outcomes for clients are in the areas of diplopia, saccadic defects, focusing difficulties from poor accommodation and convergence, visual neglect, visual perceptive difficulties, visual fields defects and more recently cortical visual blindness. Most orthoptic treatment techniques using visual rehabilitation are performed by the orthoptist in the clinic as well as giving the client home treatment exercises which can be carried out by the carer. Orthoptic techniques of treatment for visual problems are also often performed in conjunction with other therapists such as OT, Physio and speech therapy.

This presentation seeks to outline some visual rehabilitation techniques used by an orthoptist currently on brain injured clients to treat visual functioning difficulties. NSW.