Efficacy of Neuro-Optometric visual rehabilitation in Homonymous Hemianopia

Abstract

ABSTRACT Objectives To assess oculomotor dysfunction and the effectiveness of neuro-optometric visual rehabilitation in improving oculomotor parameters in participants with homonymous hemianopia. Materials and Methods Fifty subjects diagnosed with homonymous hemianopia (HH), referred through the neuro-ophthalmology department, were recruited for the study. All the subjects underwent a detailed neuro-optometric evaluation that included testing for sensory, visuo-motor and oculomotor functions. Subjects with homonymous hemianopia were then prescribed with yoked prisms and were randomized to two treatments at one month, namely group 1: yoked prisms (n = 15) and group 2: yoked prisms with in-office visual search training (n = 15). Results The mean ± SD age of the subjects was 46 ± 12 years. Subjects with HH exhibited a significant delay in the completion time, response and accuracy of tasks on proactive, saccadic and visual search parameters using the SVI compared to age-matched controls (Independent t-test, p < 0.05). A significant improvement in the reading speed and visual search parameters (RM ANOVA, p < 0.001) was seen post neuro-optometric visual rehabilitation with both yoked prisms and SVI. Statistically significant differences were observed in the reaction time of the visual search paradigms between the two rehabilitative modalities yoked (group1), yoked and SVI (group2) (Mann-Whitney U test, p < 0.001), with the group 2 showing better visual search performance outcomes compared to group 1 (yoked). Conclusion Visual search parameters among participants with homonymous hemianopia improved following combined rehabilitation (yoked prisms and visual search trainng).