& 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.