What is Neuro-Rehabilitative Optometry?

The world we see is a product of our brain’s processes.  Our eyes capture light and deliver it to the brain for processing.  Any insult to the brain, such as a stroke, will affect your vision.  

Neuro-rehabilitative optometry is a subset of optometry that uses lenses, prisms, colour, filters and vision therapy to manage visual complications resulting from acquired brain injury.  

For example, we can use posturography to determine if vision is the cause of a patient's dizziness, vertigo, ringing, and loss of balance (provided they have been medically cleared).

Posturography

Eyes2Learn Optometrists use the Balance Tracking System to assess the three central sensory feedback systems that help us maintain balance: proprioception, vision, and the vestibular system.

1. Proprioception is the inner sense of the position of one’s body part during movement.  Balance involves touch, muscle, joint and tendon receptors.  

2. Vision describes the multiple visual pathways that carry ‘spatial information’ for balance and movement.

3. The vestibular is the inner ear, providing information on motion, equilibrium and spatial orientation. 

Posturography can determine which system contributes to poor balance. If vision is the cause, the optometrist can provide neuro-rehabilitative eyecare and use posturography to monitor improvements. If another system is identified, the optometrist can also refer the patient to an ENT specialist.

Before your Neuro-optometric Evaluation

• Complete the Acquired Brain Injury Questionnaire

• Your Medicare card and Private Health Insurance card are appropriate.

• All prescription spectacles you currently use.  

• Any referrals or relevant reports from a neurologist, physiologist or occupational therapist 

Consultation Structure & Fees

1. Visual Function Evaluation

60 minutes - $220

medicare rebate of $60.05 to $90.05*  

This evaluation consists of

• Case History

• Distance Near Refraction and Acuities

• Fixation stability

• Focusing abilities

• Eye Teaming

• Stereopsis & Fixation Disparity

• Strabismus and Amblyopia

• Confrontation Visual Fields

• Colour Vision

• Ocular Health

• 3D Ocular Imaging

*If you had your eyes tested by another optometrist in the last 3 years, please provide a referral letter from your optometrist so we can provide you the full medicare rebate.  

2. Visual PROCESSING Evaluation

60 minutes session - $220

medicare rebate of $60.05

This evaluation is preferably done when the child is most alert. It consists of

• Bilateral Integration & Ocular Motor (Eye Movement)

• Posturography

• Visual Field Examination

• Motor Free Visual Form Perception i.e. visual discrimination, visual memory, visual sequencing, visual form constancy, visual figure-ground and visual closure

• Visual-Motor and Form Reproduction

• Information Span or Visual Memory

3. CONFERENCE & report

40 minutes - $180

MEDICARE REBATE OF $30.05

A meeting is scheduled to review the visual function and visual perceptual evaluation findings. Further insights or concerns about the patient are discussed here. The optometrist will discuss the treatment options and prepare a report based on the meeting outcome. Copies of the report will be forwarded to those involved in the patient's care, such as teachers, occupational therapists, and educational psychologists.

4. VISION THERAPY

40 minutes - $180

MEDICARE REBATE OF $30.05 to $60.05

Patients require vision therapy to improve their visual function. Unlike conventional treatment, neuro-rehabilitation progresses at a slower rate. This is because pushing through an activity creates significant symptoms and the condition can relapse. We liken it to lifting weights. Lifting light weights repeatedly and improving ability without significant symptoms is better than lifting heavy weights.