The Role of Neuroplasticity in the Neuro-Optometric Rehabilitation of Traumatic Brain Injury

Athletic communities have begun to take pre­ cautions to mitigate traumatic brain injury, such as using protective gear, increasing medical oversight, and establishing better return­to­play rules to protect athletes. As awareness increases, there will be a correspondingly higher frequency of people with traumatic brain injury seeking neuro­optometric evaluation and treatment. Therefore, it is imperative for optometrists to understand the signs, symptoms, and treatment of associated visual sequelae of traumatic brain injury. There are many optometric conditions caused by traumatic brain injury, including, but not limited to: convergence insufficiency, accommodative insufficiency, oculomotor dys­ function, visual motion sensitivity and light sensitivity. In particular, the functional vision problems associated with traumatic brain injury can be addressed with neuro­-optometric rehabilitation therapy. They are often due to diffuse axonal injury throughout the brain caused by shearing and tearing of the axons. People with diffuse axonal injury tend to have slower processing speeds due to impaired function at the synapse and longer neuronal pathways. Neuro­-optometric rehabilitation therapy creates an environment to facilitate neuroplastic changes within the brain, such as axonal sprouting or dendritic plasticity. This article explores possible correlation between improved clinical findings in traumatic brain injury after neuro­ optometric rehabilitation therapy and increased neurophysiological changes in brain activity after vision therapy for convergence insufficiency.