Eye Exercise
& Visual Stimulation


Research has shown that the utilization of eye movement therapy activates multiple regions throughout the brain, driving brain activation and growth. The coupling of specific eye movements with visual stimulation (colors, patterns, etc.) and specific movements allows us to activate targeted regions of the brain affected by Traumatic Brain Injury (TBI), stroke, etc.

Traumatic Brain Injury (TBI), stroke, and neurodegenerative disorders often affect how the eyes work and disrupt the visual process, interfering with how information is taken in and processed. This, in turn, causes issues relating to balance, dizziness, nausea, hand-eye coordination, reading speed/comprehension, light sensitivity, and fatigue.

At Revive, we emphasize the importance of the eye-brain connection and incorporate neuro-optometric assessments to identify the areas of the brain that have been affected by the condition. The Videonystagmography (VNG), or testing of eye movement, gives us a representation of the function of eye muscles, cranial nerves, brainstem nuclei, cerebellum and cortical regions. By measuring things like gaze stabilization, smooth pursuits, saccades, and optogenetics, it helps us to differentiate the areas of weakness. This allows us to create a unique, targeted treatment plan developed specifically for each patient.

Research has shown that the utilization of eye movements activates multiple regions throughout the brain, driving brain activation and growth. The coupling of specific eye movements with visual stimulation (colors, patterns, etc.) and specific movements allows us to activate targeted regions of the brain affected by traumatic brain injury, stroke, etc. The individual is then able to gain more from other therapies, such as occupational therapy, physical therapy, cognitive therapy, etc. If vision is not addressed, it is often difficult to recover or to reach greater potential.

Types of Eye Movements

  • Gaze Holding: Integrates and primes global pathways; starting point for all therapies (remember progression, supine/seated/standing)
  • VOR/COR w/ Fixation: start with no-no’s for pontine activation, and progress to yes-yes movements (mesencephalic).Torsional and figure 8 movements fire pontine-mesencephalic communication and activation.
  • Convergence: Translational convergence drives activation through your pons-mesencephalic pathway using otoliths
  • Pursuits: primarily targets the temporal lobe; timing components can integrate frontal lobe activity. Pursuits also help with hemispheric communication.
  • Horizontal Pursuits: Progression for patients who are just starting should always be from slow to fast. In a smooth movement pursuit, you are loosely activating the hemisphere you are pursuing toward.
  • Vertical Pursuits: In addition to helping with overall hemispheric communication, vertical pursuits rely more heavily upon and thus activate the occipital lobes to a greater degree. Diagonal pursuits activate the side of the cerebellum the pursuit is towards.
  • Saccades: Saccadic eye movements integrate the opposite hemisphere from the direction you are saccading; the amount of activation and drive depends on the velocity and amplitude of the saccade.
  • Microsaccades: Integrates specific visual field deficits; micro-saccades are often used when the patient cannot handle large gap stimuli.
  • Memory Saccades: Available through airplay on the iPad, helps with spatial awareness and orientation, integrates proprioceptive systems as well when a patient is asked to touch where the object was previously.
  • Anti-Saccades: heavily utilizes the frontal lobe, and helps to curb impulsivity.
  • Pro-Saccades: Integrates the opposite hemisphere, degree of integration depends on velocity, amplitude, and direction of the saccade. Can assist with collicular remapping and executive thinking, depending on the exercise.
  • Optokinetic: Horizontal OPK’s integrate visual-vestibular communications through the temporal cortex (MST) and is a combination of a pursuit and a saccade; horizontal OPK’s integrate both right and left hemispheres; when the pattern moves up vertically, the OPK’s target more of the frontal lobes and visual systems; when they pattern moves down vertically, the activity is more temporal. Slower speeds are for integration; faster speeds reset where the eye sits orbitally in the socket, which changes posture and center of gravity.

Research

Gaze influences finger movement-related and visual-related activation across the human brain

Changing Views of the Role of Superior Colliculus in the Control of Gaze

Characterisation and objective monitoring of balance disorders following head trauma, using videonystagmography


Screening for lifetime concussion in athletes- Importance of oculomotor measures

Saccadic latency in Parkinson’s disease correlates with executive function and brain atrophy, but not motor severity

The influence of motor and cognitive impairment upon visually-guided saccades in Parkinson’s disease

Medial Versus Lateral Frontal Lobe Contributions to Voluntary Saccade Control as Revealed by the Study of Patients with Frontal Lobe Degeneration

An fMRI study of optokinetic nystagmus and smooth-pursuit eye movements in humans.

Dynamics of saccade parameters in multiple sclerosis patients with fatigue.

Inhibitory saccadic dysfunction is associated with cerebellar injury in multiple sclerosis.

Video head impulse test can detect brainstem dysfunction in multiple sclerosis.

Using endogenous saccades to characterize fatigue in multiple sclerosis.

Impairment of Smooth Pursuit as a Marker of Early Multiple Sclerosis.

Gaze stabilization and dynamic visual acuity in people with multiple sclerosis.

Saccadic and smooth pursuit eye movements: Computational modeling of a common inhibitory mechanism in brainstem

Saccade reprogramming in Friedreich ataxia reveals impairments in the cognitive control of saccadic eye movement

Physiology and pathology of saccades and gaze holding