Preface

The purpose of this book is to provide the first textbook in post-brain injury vision rehabilitation for use by both experienced clinicians and students. It was written as a multidisciplinary text. This text should be useful not only for optometrists interested in neuro-optometry, but also for neuro-ophthalmologists, neurologists, physiatrists, occupational therapists, physical therapists, and general rehabilitation professionals such as case managers and life-care planners. Guiding vision rehabilitation following acquired brain injury is a challenging task, requiring knowledge of all areas of vision care, from the structure and function of the eye, to the functional organization of visual perception in the brain. It interacts with other rehabilitation efforts, from the patient’s ability to understand the world they see, to fine visual-motor integration, dizziness, balance, and mobility.

There is a wealth of information on vision rehabilitation in the literature. However, it has been difficult for clinicians to access, because it is scattered in pieces, not published in one reference or available from a single source. There is literature for use in the courtroom that provides references to support vision rehabilitation. However, this literature does not tell the doctor how to treat a rehabilitation patient. There are also clinical articles and a few books that give the clinical information for particular aspects of vision rehabilitation, but do not provide a comprehensive overview of the myriad of issues that must be addressed for the patient with brain injury. They also generally do not provide the research that supports intervention. This book was written for both new and experienced clinicians; it brings together the clinical information that will enable them to apply current concepts in vision rehabilitation, and it cites the literature that supports the diagnostic and therapeutic strategies applied.

We have striven to include different points of view. Although the editors are optometrists, the science in vision rehabilitation comes from experimental psychology, medicine, optometry, occupational therapy, physical therapy, and other literatures. Our introductory chapter discusses the extent of vision rehabilitation and presents vignettes of cases demonstrating the need to incorporate vision rehabilitation at every level of rehabilitation. We recruited a neurologist to write the physical substrates of vision chapter, giving a broader perspective from that typically presented in the ophthalmologic or optometric literature. Occupational therapists (OTs) wrote the multidisciplinary treatment chapter. The chapter on spatial vision was initially planned as two chapters written by optometrists (ODs)—one on eye movements/binocular vision, and one on spatial vision. However, both authors agreed that there was no way to decide where one chapter ended and the other began; we interpret space, in large part by how and where we point our eyes, and we point our eyes, in large part based on our interpretation of space. Other chapters were authored or coauthored by ODs, an OD, PhD, a certified vision therapist, an OT, PhD, a physical therapist, and an attorney, all highly respected in the field of rehabilitation following brain injury.

xi

Acknowledgments

I would like to thank all of the chapter authors who gave up practice, leisure, and family time to share their knowledge and experience—and without whom this book would not exist. In particular, thanks to Dr. Neil Margolis for sharing his brilliant clinical insights with me throughout the years; to Dr. Robert Sanet, an amazing teacher who helped me understand many things about vision; and to my coeditor Dr. Lisa H. Harvey for sharing her careful editing, her well-centered perspective, and her friendship. I am grateful for the help and support of my office staff. Thanks are due also to Karen Keeney and Dr. Carl Garbus for contributions, to Steve Suter for library assistance, to Rebecca and Trever Richards for artistic contributions, to Linda Sanet for selfless support, to David Linkhart for cover art, and especially to Katharina Gutcher, without whom this manuscript would never have made it to press.

I am also grateful to the many rehabilitation patients who have taught me so much over the years, and for whom this book was written. Lastly, I would like to thank my son, Andrew, for the love, unwavering support, and chocolate pudding with whipping cream that he provided throughout the long weekends and evenings of working on this book.

Penelope S. Suter

I am immensely grateful to all the gifted authors who have shared their knowledge in this book to advance the field of vision rehabilitation after brain injury.

The book exists because of the heartfelt desire of Dr. Penelope S. Suter, my dear friend and colleague, to get the latest, most evidence-based information into the hands of clinicians who are doing their best to serve those with brain injury from all causes. It has not been an easy task; her dedication and persistence have been extraordinary.

Lisa H. Harvey

xiii