idea is to help the patient maximize existing function and
find new tools and tricks to compensate for their problem.
Reading provides an example: The survivor puts her finger
on the first word of a line of print and then follows her
finger with her eyes as she moves it along the line of type.
“It’s a lot easier to direct your eyes doing that,” Cohen said.
“The survivor’s function is effectively improved without
healing the neurons and the neuron pathways that are the
root of the problem.”
Visual rehab specialists focus on safety of the patient so
in addition to giving them tools and strategies, they often
evaluate their home or work environment. They assess how
the survivor’s vision deficit affects their activities of daily
living: How do they cook and clean and go to the bathroom?
In the recently published rehab guidelines for stroke,
the committee said there is a very low level of evidence
to support computer-based expansion of the visual field.
Cohen agreed that the jury is still out because vision doctors
have not fully verified this treatment or deciphered how it
works. It may relate to brain plasticity, and the program is
somehow recruiting other areas where vision is processed
to take over. The problem for survivors seeking treatment
is that “these therapies are not standardized, nor broadly
adopted,” he said. “I don’t know that they should rule them
out, but I wouldn’t dive into them, particularly when they
were unproven, expensive and particularly if there were
risks involved,” he said. “Approach them with skepticism.”
“The representation of vision is widespread in the brain,
so visual loss after stroke is pretty common,” Cohen said.
“Around a third of patients will have that problem. Of those
with visual field defects, most are hemianopias . . . but we
typically don’t see complete resolution of severe visual field
cuts. They tend to be pretty resistant.”
The National Federation for the Blind is a
nationwide advocacy group. Their website lists
state and local organizations that deliver services
for people with eyesight deficits.
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