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Neuro-Optometric Rehabilitation

Vision is fundamentally a function of the brain. The way we process depth, direction, speed, and color contrast all comes down to how the brain interprets the information the eyes provide.

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Traumatic brain injury such as a concussion or stroke, or diseases such as MS, cerebral palsy, or chronic traumatic encephalopathy (CTE), can result in potentially devastating visual problems. There are also a number of inherited brain conditions which can similarly prevent the normal development of the visual system.

Can a Brain Injury or Concussion Affect
Your Vision?

A brain injury can be caused by even a mild hit to the head. Traumatic brain injury, or TBI, is a disruption of the normal function of the brain, often caused by a blow, a bump, or jolt to the head. These types of brain injuries, and the changes that occur, are often undetected in an MRI or a CT scan. A concussion may seem trivial, but it’s actually a brain injury, even if it doesn’t cause a loss of consciousness.

A brain injury can interfere with visual pathways, as it can cause a disruption in communication between the brain and the eyes, bringing on any number of visual dysfunctions. Studies show that 90% of TBI patients experience some sort of visual dysfunction, including blurred vision, visual field defects, and breathing problems. These and other symptoms can be long-term and life-altering.

An optometrist or vision therapist trained in neuro-optometric rehabilitation can effectively treat and rehabilitate the vision-related problems in those who have or are suffering from visual deficits and dysfunction resulting from brain injury or disease.

Headed by Dr. Moshe Roth and Dr. Steffani Tiomno Viveros, the Family Eye Care provides advanced neuro-optometric rehabilitation from our clinic in Old Bridge, New Jersey. We work with patients to help them improve visual function, alleviate symptoms, and regain their quality of life. We provide neuro-optometric rehabilitation to patients from Old Bridge, East Brunswick, Woodbridge, and Edison.

What is Neuro-Optometric Rehabilitation?

The brain is surprisingly elastic, meaning it can rewire and retrain itself after injury. Neuro-optometry—often lumped in with vision therapy—is a specialized field of optometry which works to actively retrain and reprogram the visual processing we rely on to properly interact and interpret the world around us. Neuro-optometric rehabilitation uses a highly-customized combination of visual exercises, specialized lenses, and targeted visual stimuli—often including of digital aids—to retrain the patient’s brain to process visual input properly.

Dr. Moshe Roth and Dr. Steffani Tiomno Viveros will determine the right course of treatment and can prevent potential long-term damage to help you get back to being the person you were before your injury.

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brain injury

General Symptoms of Vision Conditions Treated by
Neuro-Optometric Rehabilitation

  • Spatial disorientation
  • Focusing problems
  • Double-vision (diplopia)
  • Blurred vision (asthenopia)
  • Headaches
  • Nausea and dizziness (vertigo)
  • Eye strain
  • Fatigue
  • Problems accurately gauging movement, direction, and speed
  • Trouble differentiating colors
  • Hand-eye coordination and motor problems

Frequently Asked Questions About Neuro-Optometric Rehabilitation

Should I Get Neuro-Optometric Rehabilitation? If So, How Do I Get Started?

Anyone with the above symptoms or conditions should undergo a neuro-visual or vision therapy assessment.

People with motor, perceptual, or visual problems resulting from brain injury or disease can benefit from neuro-optical rehabilitation. It begins with a general eye exam to ascertain the overall health of your eyes. After reviewing any relevant medical documentation from your neurologist, occupational therapist, physiotherapist, etc, Dr. Moshe Roth and Dr. Steffani Tiomno Viveros will then perform a Neuro-Visual Assessment to pinpoint the exact visual conditions(s) present. The Family Eye Care will then craft a personalized treatment plan for your recovery.

What Causes Brain Injuries?

A type of brain injury, called traumatic brain injury, can be caused by a car accident, an explosion, a fall, physical abuse, or a sports-related injury. At times, it may seem to be only a mild hit to the head, but it can still bring about changes that seem to be very disproportionate to the injury.

Some injuries may cause the brain to bleed. Others may not bleed, or cause any pain at all. Symptoms may also not appear for days or weeks.

How Long Does it Take for Neuro-Optometric Rehabilitation to Work?

This depends on the severity of the condition or problem. You should experience improvements fairly quickly. Don’t expect a complete turn-around overnight, however. It’s a gradual process— it takes time to retrain the brain and eyes to function in unison in the way that they should, particularly if the cause of the vision problem was severe. The full amount of time required depends on multiple factors, including the cause, the individual patient, and compliance with the regimen.

How Does Brain Injury Affect Vision?

A brain injury can cause symptoms similar to Dyslexia and ADD or ADHD, as well as difficulty in knowing where you’re located in space. This can cause dizziness, difficulty with balance, and changes in posture. Some individuals have to tilt or turn their heads in order to avoid double vision.

TBI and related visual symptoms have to be taken seriously. If you’ve sustained even a mild head injury, you may have a reason for concern and should give us a call immediately.


Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths
2002–2006. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.

Report to Congress on Mild Traumatic Brain Injury in the United States: Steps to Prevent a Serious Public Health Problem. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2003.

Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry 2007;78(4):155-61.

Rowe F.J. Stroke survivors’ views and experiences on impact of visual impairment. Brain and Behavior, 2017; e00778 DOI: /

Leslie S. Myopia and Accommodative Insufficiency Associated with Moderate Head Trauma, Opt Vis Dev 2009;40(1):25-31.

Cohen, Alen H. Vision rehabilitation for visual-vestibular dysfunction: The role of the neuro-optometrist, NeuroRehabilitation, vol. 32, no. 3, pp. 483-492, 2013
HAN M.E. (2007) The Role of the Neuro-Rehabilitation Optometrist. In: Elbaum J., Benson D.M. (eds) Acquired Brain Injury. Springer, New York, NY

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Serving Neuro-Optometry Patients From:

Old Bridge | East Brunswick | Woodbridge | Edison | and throughout New Jersey