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Writer's pictureRoxana Cziker
Oct 28, 20223 min read

Evidence-based research on neuro-visual assessment and rehabilitation in aquired brain injury

Updated: Feb 28, 2023

Visual impairment is common after traumatic brain injury (TBI). Studies estimate that as many as 90% of people with TBI experience injury-related vision impairments (Ciuffreda et al., 2007), of which 56%–80% are oculomotor (Ciuffreda et al., 2007; Schlageter et al., 1993). The oculomotor system has representation in all brain lobes, making eye movements easily impaired as a result of TBI (Baker & Epstein, 1991; Helvie, 2011; Leigh & Zee, 2006).


Eye movements include pursuits, saccades, vestibular ocular reflexes, convergence, and fixations (Leigh & Zee, 2006). Oculomotor dysfunction can negatively affect the execution of daily life tasks such as reading, computing, and community participation (Ciuffreda et al., 2007; Kapoor & Ciuffreda, 2002; Warren, 1993a).


Evaluation and rehabilitation of oculomotor functions play a key role for individuals suffering from TBI (Warren, 1993a, 1993b). Both remedial protocols and compensatory interventions can be used (Powell & Torgerson, 2011; Citation: Berryman, A., Rasavage, K., Politzer, T., & Gerber, D. (2020). Brief Report—Oculomotor treatment in traumatic brain injury rehabilitation: A randomized controlled pilot trial. American Journal of Occupational Therapy, 74, 7401185050. https://doi.org/10.5014/ajot.2020.026880 The American Journal of Occupational Therapy, January/February 2020, Vol. 74, No. 1 7401185050p1

Brief Report Warren 1993a, 1993b).


A selection of very interesting articles:

  1. Berthold-Lindstedt M., Johansson J., Ygge J. and Borg K. How to assess visual function in acquired brain injury - Asking is not enough. Brain and Behaviour. February 2020; DOI: 10.1002/brb3.1958 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882154/pdf/BRB3-11-e01958.pdf)

  2. Johansson J., Berthold-Lindstedt M. and Borg K. Vision therapy as part of neurorehabilitation after acquired brain injury - a clinical study in an outpatient setting. Brain Injury. 2021, Vol. 35 No. 1, 82-89. https://doi.org/10.1080/02699052.2020.1858495 (https://www.tandfonline.com/doi/pdf/10.1080/02699052.2020.1858495?needAccess=true)

  3. Dundon N.M., Bertini C., Ládavas E., Sabel B.A., and Gall C. Visual rehabilitation: visual scanning, multisensory stimulation, and vision restoration training. Frontiers in Behavioural Neuroscience. July 2015; Vol. 9. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515568/pdf/fnbeh-09-00192.pdf)

  4. Hac N.E.F. and Gold D.R. Neuro-visual and vestibular manifestation of concussion and mild TBI. Current Neurology and Neuroscience Reports (2022); 22:219-2028. https://doi.org/10.1007/s11910-022-01184-9 (https://link.springer.com/content/pdf/10.1007/s11910-022-01184-9.pdf)

  5. Ioanta S. Visual neuropsychology in development: Anatomo-functional brain mechanisms of action/perception biding in health and disease. Frontiers in Human Neuroscience. May 2021; Vol. 15. doi: 10.3389/fnhum.2021.689912 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203289/pdf/fnhum-15-689912.pdf)

  6. Heutink J., Indorf D.L. and Cordes Ch. The neuropsychological rehabilitation of visual agnosia and Balint´s syndrome. Neuropsychological Rehabilitation. 2018; 29:10, 1489-1508. (https://www.tandfonline.com/doi/pdf/10.1080/09602011.2017.1422272?needAccess=true)

  7. Armstrong R. A. Visual problems associated with traumatic brain injury. Clinical and Experimental Optometry. 2018; 101: 716-726. DOI:10.1111/cxo.12670

  8. Berryman A., Rasavage K., Politzer T. and Gerber D. Oculomotor treatment in traumatic brain injury rehabilitation: A randomized controlled pilot trial. The American Journal of Occupational Therapy. January/February 2020. Vol. 74, No. 1 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018460/pdf/7401185050p1.pdf)

  9. Murray N.P., Hunfalvay M., Roberts C.-M., Tyagi A., Whittaker J. and Noel C. Oculomotor training for poor saccades improves functional vision scores and neurobehavioral symptoms. Archives of Rehabilitation Research and Clinical Translation. 2021; 3:1-8 (https://reader.elsevier.com/reader/sd/pii/S2590109521000306?token=E5EB0DFE75D749BFC93697BA13E6404CA468AA6F556F0039A251B2BBDC3FD6172FEF33EAA04263368D2552E22B519EBC&originRegion=eu-west-1&originCreation=20221028130805)

  10. Wilterson A.I., Nastase S.A., Bio B.J., Guterstam A. and Graziano M.S.A. Attention, awareness, and the right temporoparietal junction. PNAS. 2021 Vo. 118 No. 25:1-10. https://doi.org/10.1073/pnas.2026099118 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237657/pdf/pnas.202026099.pdf)

  11. Kapoor N., Kenneth J. and Han Y. Oculomotor rehabilitation in acquired brain injury: A case series. Arch Phys Med Rehab. Vol. 85, October 2004. (https://reader.elsevier.com/reader/sd/pii/S0003999304002928?token=20E0C62562026541718D19FB0AC1A9CB903357C25328C0DBFE16628349380294D9F62943C4B2126889F91A3D9765476B&originRegion=eu-west-1&originCreation=20221028131435)

  12. Schmitter-Edgecombe M. and Robertson K. Recovery of visual search following moderate to severe traumatic brain injury. J Clin Exp Neuropsychol. 2015; 37(2): 162-177. doi:10.1080/13803395.2014.998170 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355332/pdf/nihms652993.pdf)

  13. Walz J., Mani R., Alnaemasi M.M. and Khuu S.K. Deficit in traumatic brain injury: A systematic review and meta-analysis. Frontiers in Human Neuroscience. July 2021. Vol

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