Rehabilitation Therapy

*Neuro-optometric rehabilitation should not be confused with vision therapy, as not all doctors who offer vision therapy are trained in neuro-optometric rehabilitation.

Neuro-optometric rehabilitation is a personalized treatment regimen for those with visual deficits resulting from traumatic brain injuries (TBI), physical disabilities or other neurological issues, such as a stroke. The vision complications are not associated with visual acuity (20/20) but rather with eye teaming, focusing, and tracking, all of which can result in difficulties in reading and playing sports. 

Neuro-optometric rehabilitation promotes recovery through various therapies and activities that retrain the neural processes of the brain. Your brain's ability to change and adapt is called neuroplasticity.  By using specific eye-training exercises, one can rewire the brain to improve eye function. Just as with other rehabilitation methods, the earlier one starts the eye exercises, the better the chance of recovery and sight improvement. 


Depending on the type and severity of problems detected, the eye doctor will develop a treatment plan uniquely designed to eliminate vision symptoms and difficulties. Treatments typically include specialized glasses to help with visual processing or in-office and at-home neuro-rehabilitation procedures to reduce symptoms and promote visual recovery. This includes exercises to eliminate or reduce double vision and improve balance, gait, visual information processing, cognitive skills, visual memory, motor skills, and more. 

All patients suffering from neurological disease, trauma or conditions should be referred to a doctor of optometry for a comprehensive eye exam and neuro-optometric services. 

It is important to note that a single type of vision rehabilitation treatment is often not enough to address all of the patient’s needs. This is why an interdisciplinary, integrated team approach plays an important role in the rehabilitation of patients with traumatic brain injuries. 

Traumatic Brain Injury, Stroke, and Concussions

Neuro-optometrists most commonly treat traumatic brain injury, mild traumatic brain injury, and stroke.

Traumatic Brain Injury (TBI)

Traumatic brain injury (TBI) occurs when a sudden injury damages your brain. There are two kinds of TBI: a closed head injury that doesn't break through the skull (yet may still cause brain damage), and a penetrating head injury, which breaks through the skull.

Approximately 47% of traumatic brain injuries are caused by falls, particularly among young children and those over 65 years of age. Other TBI injuries can result from blunt force trauma (15%), car accidents (14%), and violent physical assaults (9%).

The statistics on TBIs are quite startling. In Canada, the cases of traumatic brain injury outnumber breast cancer, spinal cord injury, multiple sclerosis, and HIV/AIDS combined.

In fact, an estimated 1.5 million Canadians are living with and a traumatic brain injury, and the numbers keep rising.

Because more areas of the brain are used to process vision than any other system, traumatic brain injuries often result in vision problems. In fact, studies show that 90 % of TBI patients experience some form of vision disruption, which is caused by interrupted communication between the eyes and the brain. This results in blurred vision, reading difficulties, sensitivity to light, double vision, among other symptoms.


If you experience a traumatic brain injury, make sure to see a neuro-optometrist who has special training in TBI-related visual aberrations.

Mild Brain Injury (MTBI) - Concussions

Traumatic brain injury causes brain dysfunction that can range from mild (concussion) to severe. Though considered mild, a concussion is still a brain injury that can cause ongoing debilitating symptoms and alter the normal function of one’s brain.

The most affected demographic are children and teens, and of those, more than 60% experience visual symptoms.  It's not uncommon for patients to experience blurred vision following a concussion, which can be caused by a misalignment of the eyes when attempting to focus on a single object or target. Other post-concussive visual problems can result in physiological or cognitive complications.


Cognitive symptoms may include:


Memory problems

Difficulty thinking

Attention deficits

Mood swings


Visual symptoms may include:

Sensitivity to light

Blurred vision

Reading difficulties

Loss of peripheral vision


Double vision

If you or a family member has sustained a concussion or even whiplash — such as from a violent blow to the head — we strongly urge you to get your eyes examined as soon as possible. It's important to note that even though you may not have been diagnosed with a concussion, whiplash is strongly related to a concussion and shares many of its symptoms. If the eye doctor detects any problems, treatment will begin before the issues increase in severity.


A stroke (also called a cerebrovascular accident, or CVA) occurs when there's a sudden interruption of the blood supply to part of the brain or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. The initial symptoms of a stroke often include sudden loss of speech, vertigo, confusion, weakness or paralysis on one side of the body, headache, seizure and ocular disruptions.

About 60% of stroke survivors have a visual impairment resulting in diminished central or peripheral vision, eye movement abnormalities, or visual perceptual deficits.

Because strokes affect the brain’s information processing, the impact it has on a person's visual function varies depending on the location and severity of the insult. The ocular changes associated with stroke can be categorized as sensory (visual acuity and visual field), motor (extraocular muscle motility) and perceptual.

Though some people immediately notice vision changes, not all visual impairments occur right after a stroke. Generally, they will first experience an inability to organize and make sense of visual information in front of them, and/or develop issues with balance and posture.

Contact a neuro-optometrist who will custom-design an effective neuro-rehabilitation therapy program to treat any vision problems related to stroke or traumatic brain injury.


Post-stroke vision impairment symptoms may include:

  • Blurry vision
  • Double vision
  • Visual field loss
  • Diplopia
  • Eye movement abnormalities
  • Visual perceptual defects
  • Sensitivity to bright light (photophobia)
  • Inability to recognize familiar people or objects