Vision Program Focuses on Independence

When someone endures a brain trauma, vision problems are often the unwelcome companion of concussion, traumatic brain injury (TBI), or stroke.

Patients may not know they have visual deficits until seemingly unrelated issues arise. An awkward gait, imbalance, problems with activities of daily living or learning impairment can be the clinician’s clue that damage is present.

Centre for Neuro Skills® (CNS) believes that vision therapy is an essential aspect of comprehensive care. For over 20 years, the CNS vision program has helped patients recover from post-injury visual deficits, allowing them to work, live safely, and even drive again.

“The visual system is a silent system,” said David Harrington, MBA, OTR/L, CBIST, Director of Operations at CNS. “It takes a skilled clinician to detect problems, which may linger undetected for years.”

Visual Therapies Enhance Rehabilitation

Addressing visual deficits is crucial in a successful recovery. It enhances the clinical efficiency of other therapies, since vision is connected to movement, reasoning, hearing, and speech.

“The clinical staff must understand the visual system,” David emphasized. CNS case managers and therapists are trained in this area, and they collaborate with vision specialists to maximize treatment outcome.

Some of the red flags that therapists look for are erratic eye movements or eyes that don’t converge on an object. Once vision damage is suspected, occupational therapists administer three eye screens, which assess the optic system, the visual field, and visual perception/processing information.

The screening results are used to create an individualized treatment plan that includes vision therapy, where needed. Because the brain’s spatial, visual, perceptual, and cognitive functions are all related to sight, treatment planning encompasses many disciplines that support vision.

When testing is complete, patients sometimes require vision therapy and specialized glasses, and, David notes, “a pair of standard lenses won’t do.”

CNS refers these patients to a consulting neuro optometrist who understands TBI, tests for specific optic and brain pathway damage, and prescribes lenses for each patient’s deficits.

These specialists also help refine the patient’s treatment plan, collaborating with CNS occupational, physical, and speech therapists to form a dedicated vision and rehabilitation team.

Technologies Build Skills, Support Patient Goals

“Our objective is to remediate the visual system so patients can scan the environment for hazards, read a prescription bottle, and understand directions,” David added. “When facilities don’t address vision problems, it can really delay a patient’s progress.”

To meet that objective, CNS offers tools and technologies to assess patients and correct neuro pathways.


These tools include:

  • Dynavision: a testing and visual rehabilitation system that determines eye function and improves acuity
  • Tranaglyphs: red/green glasses to strengthen 3D vision
  • Vectograms: polarized lenses that help eyes track together and form depth perception


The outcome of a comprehensive vision program benefits patients in the long term. A core CNS philosophy is providing patients with the skills to achieve lifelong independence. Staff works with payers, caregivers, and families to provide updates on vision tests and patient milestones along the path of rebuilding skills.

Hope in Sight: A Patient Returns to Reading, Working, Driving

In his 20 years as a CNS executive, clinician and case manager, David has seen remarkable success stories.

He recalled one man whose vision was so impaired that his eyes could only converge on objects that were ten feet from his nose. Normal convergence distance is two inches.

His visual system conflicted with his vestibular system, which caused confusion, created nausea, and increased risk of further injury. He also couldn’t dress himself or read prescriptions. In the CNS vision program, he improved convergence from ten feet to one foot, allowing him to drive, work, and abandon the cane he depended on.

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We will gladly answer all or your questions about rehabilitation at Centre for Neuro Skills.


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