The Importance of Vision Screenings in Neurorehabilitation


Guest poster Dr. Val Neufeld, Lead Occupational Therapist and Remedial Vision Rehabilitation Specialist from Centre for Neuro Skills from Dallas, TX brings us her expertise on the importance of vision screenings in neurorehabilitation:

It is not news that visual and visual-perceptual impairments associated with brain injuries are prevalent, with estimates as high as 90% (Jacobson & Marcus, 2011).

Visual and visual-perceptual deficits can significantly influence participation in meaningful activities. People with neurological deficits that experience visual impairments may have disabling symptoms such as difficulty with functional ambulation placing them at a higher risk for falls, decreased ability to complete activities of daily living (ADLs) such as getting dressing, grooming and instrumental activities of daily living (IADLs) such as grocery shopping or reading a medication label, and may develop higher instances of depression.

Basic functions of vision and deficits related to cognitive issues

If we consider that there are three basic functions to vision: visual acuity, visual perceptual skills, and oculomotor control (Warren, 2013). People with neurological deficits frequently experience visual complications as a result of their injury/condition (Cockerham et al., 2009). These visual deficits include visual field deficits (46%), convergence insufficiencies (31%-47%), oculomotor deficits (10%-30%), and diplopia (6%-9%) (Suchoff et al., 2008). Vision deficits such as convergence insufficiency, binocular deficits, suppression, etc., also have a negative impact on daily activities, and should be screened for sooner rather than later.

When you take into account how much of day-to-day life is processed by vision, it is fair to assume that vision deficits resulting from neurological issues have the potential to delay recovery and outcomes and decrease quality of life.


Abstract photo by kjpargeter

Lack of vision screening in the neurorehabilitation world

I have taken a significant amount of time reviewing the literature in order to provide varying levels of insight into this manner.  The literature on vision deficits alone is robust yet why is there a lack of vision screenings in the neuro-rehabilitation world?

Whether patients’ injuries are mild or severe, many experience problems that interfere with their ability to complete functional tasks. Patients also frequently face worsening cognitive dysfunction after neurological disorders, brain injuries, etc.

As therapists in the neuro-rehabilitation setting we must consider all the areas of deficits, look at the internal and external factors affecting functional performance, and also take into account the end goal based on the patient’s preference and our own knowledge and skill level.


  • Valentina Neufeld: Occupational Therapist & Remedial Vision Rehabilitation Specialist

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2 thoughts on “The Importance of Vision Screenings in Neurorehabilitation

  1. Víctor olloqui Tuesday September 22nd, 2020 at 07:31 PM

    Yo tengo la respuesta. Soy Optometrista y psicólogo y lo que ocurre en España no pasa en EEUU. Aquí quien visita es el oftalmologo, que no se dedica a la neurorehabilitación y sus conocimientos y práctica clínica en estos caso es mínima. Además hay pocos Optometristas en consultas que se dediquen a la funcionalidad de la visión y pocos con conocimientos en procesos perceptivos. Los Optometrista tenemos muchas herramientas para mejorar insuficiencias de convergencia, diplopia, supresiones, motilidad ocular, tanto con lentes como con terapia visual. Es una pena que no aportemos nuestros conocimientos tanto en traumatismos craneales, acv, tumores, intervenciones quirúrgicas porque podríamos aportar muchas mejoras en la calidad de vida de estas personas.

  2. Val Wednesday October 7th, 2020 at 09:53 PM

    I agree with you. It is important we continue to advocate for the patients but also for each other in the medical field. We need to continue to work towards a multidisciplinary approach– which, has shown to increase efficiency of treatment and overall prognosis. Thank you for your comments. I loved reading about what is happening where you are. 🙂

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