TVTO is located beside Fairview Mall at 5 Fairview Mall Dr., Suite 410, Toronto, Ontario M2J 2Z1

Opening Hours : Mon-Tues: Open @ Noon / Wed-Sat: Open @ 9:30am
  Contact : 416.498.3438

Neuro-optometric Rehabilitation

Neuro-Optometric Rehabilitation Programs 

  • To determine how a person’s visual system has been affected by an injury or disease process we book them for a neuro-optometric examination
    • This is a specialized set of visits done over 1-3 days (depending on ability to tolerate testing)
    • Testing includes but is not limited to:
      • In-depth history of problem/symptoms
      • Refraction: testing of eyes focus
      • Stereoacuity (ability to see 3D)
      • Saccades and Pursuits: eye movements, these are tested grossly as well as using standardized tests
      • Eye movements required by reading- compared to age appropriate normative data
      • Eye alignment: presence of a high phoria and/or strabismus
      • Ability to converge and diverge the eyes: look inwards and look outwards
      • Ability to change focus/accommodate
      • Presence of a visual midline shift
      • Chiroscopic tracing: demonstrates how a person sees space
      • Vestibular Ocular Reflex testing
      • Visual Motion Sensitivity testing
      • Visual Field Testing
      • Visual Neglect Testing
      • Visual Perception Testing
    • A treatment plan is then provided at the conclusion of the visit, this may include:
      • Referral to other health care providers
      • Specialized glasses (may contain prism, filters and/or colour filters)
      • Lifestyle modifications
      • Personalized Neuro-Optometric Rehabilitation Program

Post- Concussion Patients:

  • Studies show that up to 90% suffer an associated visual dysfunction:
    • Blurry vision
    • Photophobia (light sensitivity)
    • Visual field loss
    • Headaches associated with visual tasks
    • Ocular motor dysfunction (problems moving the eyes and tracing)
    • Convergence Insufficiency (difficulties crossing the eyes)
    • Diplopia (double vision)
    • Reading difficulties
    • Accommodation Dysfunctions (difficulties focusing)
    • Visual Midline Shift
    • Post Concussion/trauma Vision Syndrome
    • Visual Motion sensitivity (troubles when moving or seeing objects/space that moves)
    • Reduced Vestibular Ocular Reflex gain
  • Many patients who have had a trauma can get a condition called Post Trauma Vision Syndrome
    • Symptoms include:
      • Double vision
      • Headaches
      • Dizziness/nausea
      • Difficulties concentrating
      • Reduced blink rate-/dry eye
      • Spatial disorientation
      • Losing their place when reading
      • Appearance of stationary objects moving when they aren’t
      • Recoil from objects moving towards them
      • Visual memory difficulties
    • Post-Trauma Vision Syndrome is a dysfunction of the ambient visual process. The visual process is made up of two parts Focal and Ambient. The Focal process provides information about “what” an object is in the visual field. It is generally associated with the function of the macula which is the part of the eye that allows humans to see small details. The Ambient process provides information about “where” a person is in space. Information from the ambient process is required for balance and movement.   These systems need to operate in balance, when there is a dysfunction in the Ambient Visual System, Post-Trauma Vision Syndrome occurs.
      • Treatment involves specialized glasses and neuro-optometric rehabilitation exercises to rehabilitate the ambient visual process.
    • Patients who have had a concussion can also get visual midline shift syndrome. This is a deficiency in either the ambient visual system and/or the motor system. Patients perceive space as being shifted. It can be shifted either right/left or anterior/posterior. This causes difficulties with balance.
      • Treatment involves specialized glasses and neuro-optometric rehabilitation exercises to rehabilitate the ambient visual system and the motor system.

Neuro-optometric Rehabilitation is not covered by OHIP. Some private insurances may cover some of the care. For MVA patients, we do bill through HCAI and are FSCO licensed. We also work with WSIB patients.

Stroke Patients:

  • Many patients who have suffered a stroke may also have visual symptoms as a result and can include:
    • Blurry vision
    • Double vision
    • Visual field loss
    • Visual neglect
    • Visual midline shifts
    • Ocular motor dysfunction
    • Reading difficulties
  • Visual field loss such as a homonymous hemianopia (loss of right or left side of the visual field) or quadranopia (loss of a specific quadrant) is a common visual problem after a stroke. Patients may experience this as a change in their vision, they may bump into objects or trip easily and  have reading difficulties. Treatment of these conditions involves rehabilitation exercises such as scanning techniques to help with compensating the field loss.
  • Another common effect of a stroke is visual neglect. Visual neglect is a condition that describes a patient ignoring one side of space or they lack awareness of one side. For example, they may not ‘notice’ one side of a clock or a plate of food. The severity of visual neglect can range and treatment plan will depend on the severity. It may involve eye movement exercises or use of occlusion techniques to help improve awareness or attention of the affected side.