Neuro-Optometric Rehabilitation Accelerates Post-Concussion Syndrome Recovery in a Professional Athlete – A Case Report Presenting a New Paradigm

Abstract

Background: Optometrists are becoming increasingly instrumental in the care of brain injured patients. Within the profession of optometry, a segment of optometrists has become highly trained and skilled in rehabilitation of vision dysfunctions and therefore is integral in the interdisciplinary management of a patient’s overall recovery from acquired brain injury. No system provides more neurosensory input to the brain than vision. Therefore, optometry has an obligation to and is best prepared to provide this area of care referred to as neuro-optometric rehabilitation. Case Report: A professional soccer player suffered a head injury during competition. He was diagnosed with a mild traumatic brain injury (concussion) and was unable to obtain complete resolution of symptoms despite current standard return-to-play protocol administered by the team medical staff. Symptoms included intermittent blurred vision during movement, mild photophobia, and feeling somewhat “not present”. The team medical staff included a sports medicine physician, head athletic trainer/physical therapist, and a neuropsychologist. Neurooptometric consultation was requested for the athlete by the team physician to determine if vision dysfunction was contributing to the athlete’s persistent symptoms. He was diagnosed with vision dysfunctions presumably associated with the concussion and neurooptometric rehabilitation was prescribed. Conclusion: The clinical findings and treatment in a case of post-concussion syndrome involving associated vision dysfunctions are described. Neuro-optometric rehabilitation utilizing a unique paradigm remediated the vision dysfunctions of the athlete and eliminated his post-concussion symptoms. This in turn facilitated his return-to-play process. The paradigm applied began with passive, inputbased, bottom-up therapy accompanied by gradual introduction of active, output-based, top-down techniques. In recent years, this author has found this paradigm to be more effective than a top-down approach when non-oculomotor based vision dysfunctions are included in the post-concussion patient clinical findings.