NORA Issues Response to Medical Groups' Joint Guidance of Vision Disorders Following a Concussion
Below is the response from the Neuro Optometric Rehabilitation Association (NORA) regarding the recent statement from various ophthalmic organizations in reference to concussion guidance. The NORA statement reads:
"The American Academy of Ophthalmology, the American Academy of Pediatrics, the American Association for Pediatric Ophthalmology and Strabismus, and the American Association of Certified Orthoptists issued a statement to provide guidance on screening, identifying, and initiating clinical management of visual symptoms in pediatric patients after concussion.
According to their statement, specialists with experience in comprehensive concussion management—such as those in sports medicine, neurology, neuropsychology, physiatry and ophthalmology—can help with further assessment and treatment as necessary.
Doctors of Optometry serve an integral role as members of healthcare teams devoted to the care of brain injured patients, yet, in their statement, this group of medical associations failed to include optometrists who have been educated and trained to diagnose and manage ocular dysfunctions and visual processing deficits related to brain injuries.
Clinicians regularly assess a concussion or other acquired brain injury to the symptoms that an individual manifests at the time of injury but, unfortunately, vision-related problems are often overlooked during initial evaluation. Individuals who have experienced some sort of neurological insult or injury, and who are experiencing visual symptoms, can benefit from a vision assessment from a Neuro-Optometric Rehabilitation Optometrist, an eye care professional who specializes in the diagnosis, treatment, and rehabilitation of neurological conditions adversely affecting the visual system.
Neuro-optometric therapy is a process for the rehabilitation of visual/perceptual/ motor disorders. Optometrists specializing in this area examine not only the visual issues, but also other subtle factors involved in the complex visual process, such as posture, spatial awareness, visual memory, and motor output -- all areas that can have wide-ranging effects on daily activities and on quality of life.
“When a person has a brain injury, often a single approach to rehabilitation is not enough to address all of his/her needs,” notes DeAnn Fitzgerald, OD, president, Neuro Optometric Rehabilitation Association (NORA). “An integrated team approach that incorporates the training and expertise of a variety of professionals can play a vital role in rehabilitation. NORA stresses the importance of an interdisciplinary, integrated team approach in the diagnosis and rehabilitation of patients with concussions, stroke or other neurological deficits.
In their statement, these groups also identify "vision therapy" – a practice commonly promoted for the treatment of concussion—as an intervention for which there is insufficient evidence of efficacy. Vision therapy has been found to assist the visual system to recover from issues that are often linked with post-concussion syndrome and is supported by evidence-based and peer reviewed published articles.
NORA offers resources to help patients and caregivers find the help they need following a concussion as well as tools and resources for optometrists and other healthcare professionals. NORA also features a doctor locater on its websites for access to providers who specialize in brain-injury related visual problems. For more information, visit www.noravisionrehab.org.