As many of you know, optometrists aren’t just the folks who examine eyes for glasses and contacts. They are healthcare providers who help to maximize patient health by maximizing eye health and visual acuity. It is well known that they work with primary care physicians to monitor patients with diabetes and hypertension, but what many don’t know is that optometrists are now working with neuropsychologist and occupational therapists in areas of concussions, Traumatic Brain Injuries (TBIs) and low vision.
What lead to these kinds of collaboration? In the case of TBIs, it is a combination of factors. Since 2007, athletes from different sports have donated their brains to the Boston University Chronic Traumatic Encephalopathy Center to be examined after death. In addition, many veterans of the Afghanistan/Iraq war are being treated for TBIs that they experienced during their tour of duty. These developments lead to a better understanding of what happens to a person when they experienced a brain injury.
Vision is affected when someone has a TBI. Symptoms can include blurred vision, sensitivity to light, dizziness, and headaches, just to name a few. Sisters Dr. Christie Russell-Villnow, an optometrist who specializes in vision rehab and TBI rehab and Dr. Leslie Russell-Martin, a neuropsychologist who works with patients who experienced a TBI, work together to manage these complex cases. Dr. Russell-Martin noticed that many of her patients had vision issues related to their TBI. Since her sister is an optometrist, she encouraged her to learn more about TBI and visual processing, so that she can work with her TBI patients.
In addition to optometry, there is occupational therapy. Since the visual pathways make up more than 50 percent of the brain’s pathways and these pathways are affected when someone has a concussion or when a child has developmental delays, occupational therapy in combination with vision therapy can help improve performance in the activities of daily living.
Stan Appelbaum, OD, FCOVD, and Barbara Bassin, OTR/L, BCP are a husband and wife team of optometrist and occupational therapist. They have a practice where they offer optometric vision therapy and sensory-integration-oriented occupational therapy. Having two therapies under one roof is a plus for the patient. Both coordination and alertness improve. The work that Appelbaum and Bassin are doing has been shown to help those who have plateaued with other therapies. The outcomes that they have seen lead them to recommend that pediatric patients start vision and occupational therapy before starting other therapies. This allows children to get more benefit from other therapies since their brain is more responsive.
“Combining vision therapy with occupational therapy seems to dramatically enhance the benefits of both therapeutic treatment programs in children with attention problems and autism,” said Appelbaum. “Many parents have reported positive results with this approach, particularly if occupational and vision therapy is done on an intensive basis.”
Optometrists are more than the folks who do refraction and work the phoropter. Their expertise in vision can help improve the outcomes of those who experienced a TBI or who need occupational therapy.