Vision Therapy for Concussion Rehab (with Dr. Shirley Blanc) | ACD - Ep. 122

Dr. Shirley Blanc is a neuro-optometrist in downtown Toronto. She is a Fellow and advisory board member of NORA (Neuro Optometric Rehabilitation Association), and a medical advisory board member and contributor to Complete Concussion Management. In this episode we discuss common visual presentations and symptoms that both patients and clinicians should be on the look out for in post-concussion patients. We also discuss treatment options and the benefit of the multidisciplinary approach.
You can find more about Shirley such as appointment bookings by visiting: www.concussionvisionclinic.ca
Resources Discussed:
Visual Snow - www.visualsnowinitiative.org/
Anti Flicker Screens - BenQ, ViewSonic, Asus, gaming-computers with refresh rate above 140 Hz
Finding a Neurooptometrist:
-Canada - www.visiontherapycanada.com/
-USA - noravisionrehab.org/
-Australasia - www.acbo.org.au/
-UK - babo.co.uk/ (edited)
Visual Snow Initiative:
visualsnowinitiative.orgvisualsnowinitiative.org
British Association of Behavioural Optometrists - Home
babo.co.ukbabo.co.uk
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Timestamps:
0:01 - Intro
1:20 - What is neuro optometry
5:50 - Behavioural Optometrist vs Concussion Therapist
8:25 - Most common visual problems found in concussion patients
25:55 - Common symptoms to see a neuro optometrist
30:46 - What is visual snow?
35:20 - Things for physicians to look for
102:28 - Light Sensitivity
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Interested in learning more about the treatment and management of concussion?
-- CONCUSSION PATIENTS! Learn how to treat your concussion from home in Dr. Cameron Marshall’s weekly online workshops. Click here to learn more: smarturl.it/workshopcdoc
-- CLINICIANS AND REHAB THERAPISTS (PT, DC, OT, AT, etc.)! Learn how to treat ANY Concussion Patient that enters your clinic in Dr. Cameron Marshall’s weekly online workshops. Click here to learn more: smarturl.it/workshopcc
Follow Dr. Cameron Marshall on Instagram for daily information on concussion: @completeconcussions

[@JKnSK]

You hit the nail on the head...poor patients that with a concussion and serious issues have to try and navigate this all alone. AND insurance won't pay for any of it!! It's insane. I'm a strange case of PCS due to CIRS caused by toxic mold exposure. So extreme neuroinflammation, constant distorted vision. I am working on all the gut, immune system issues... but I need vision therapy. But cannot afford it on top of all the other medical stuff that insurance won't pay because no regular Drs acknowledge CIRS and mold illness. I have young kids, can't work, can't drive, can't look forward when riding in the car. Just horrible

[@CompleteConcussions]

Sorry to hear that :(. Maybe one day they will...

[@velvetstaub8443]

Therapy works! Do the exercises daily it works!

[@kristopherlee6555]

What excercises do you recommend for visual snow?

[@revaholic]

34:10 I find it really interesting that you brought up blood flow and dysautonomia relating to visual snow. I have visual snow and have suspected that dysautonomia has to do with my issue, because my visual snow symptoms particularly wavey vision and lightheadness are affected by heart rate, exercise, and stress. I believe I have some form of dysautonomia connected to my visual snow but it's so hard to find doctors who can connect the dots for me for conditions that are so poorly understood.

[@CompleteConcussions]

I have also spoken with other neuro-optometrists who study this area and they suggest that inflammation plays a critical role as well - inflammation is all related to diet, gut, hormones, sleep, exercise etc (and much of dysautonomia is intertwined here as well).

[@revaholic]

@@CompleteConcussions Thank you for that tip. I am experiencing sudden lightheadedness and imbalance especially when using computer screens and in high stimulus environments that I can't really figure out, since I feel fine in moving vehicles

[@Robertsmith-un5cu]

if you have visual snow, welcome to hell my friends

[@MsItalianspice]

They have missed. Was told my eye sight was normal not need a prism on my right lens. My balance since 2018 was bad. And dizzy since 2022. Was diagnosed with nystagumus. And ci. never had covid.

[@walwala78]

I’m interested in this but have a strong (read very expensive) prescription for my glasses now. Would these go over the current ones - prisms or colored lenses etc- or do I need a whole new pair?

[@veronicaespinosa4158]

How long does it take to fix smooth pursuits and sac cafes with vision therapy after a concussion?

[@Emily-dn3cs]

What is your opinion of Syntonics as part of vision therapy?

[@jeanpauljeanpaul2530]

My neuro-optamologist in the GTA says not to waste my time and money with vision therapy. He claims nothing that I can do to improve my concussion. So just get on with life,

[@asusasus3277]

I suspect vision therapy is for people who have issues with habituation, so it forces them to go out there and push themselves, push the limits so they get better

[@dr.cameronmarshall1032]

That is the general thought of most physicians (which ophthalmologists are), however the evidence continues to grow demonstrating that it can be helpful for patients with certain visual dysfunctions. We are still early in our discovery of this. Anecdotally, we've had many many patients find great relief by rehabilitating these mechanisms.

[@velvetstaub8443]

Therapy works!!! I have been doing vision, neck, binocular stress, motion, convergence, and tunnel vision therapy work with my physical therapist for the past year. It takes time and daily exercises. I’m getting better, I was able to pass my drivers test because of the improvement with my eyes… and I have less headaches. Please, try the exercises it works but you have to be patient and keep at it for at least a month. My red / green glasses and polarization glasses have helped to retrain my brain to use my eyes again.

[@jamiecaskie665]

It changed my life within 6 months. With concussions being so unique, its not going to be the correct path for everyone. That said, with a proven binocular visual impairment, it is certainly worth exploring. I am a huge advocate, and I'm hopeful this can be understood in greater confidence by the greater medical community over time.