Effect of oculomotor rehabilitation on vergence responsivity in mild Traumatic Brain Injury
A range of dynamic and static vergence responses were evaluated in 12 individuals with mild traumatic brain injury (age: 29 +/- 3 yr) having near vision symptoms. All measures were performed in a crossover design before and after oculomotor training (OMT) and placebo (P) training. Following OMT, peak velocity for both convergence and divergence increased significantly. Increased peak velocity was significantly correlated with increased clinically based vergence prism flipper rate. Steady-state response variability for convergence reduced significantly following OMT. The maximum amplitude of convergence, relative fusional amplitudes, and near stereoacuity improved significantly. In addition, symptoms reduced significantly, and visual attention improved markedly. None of the measures were found to change significantly following P training. The significant improvement in most aspects of vergence eye movements following OMT demonstrates considerable residual brain plasticity via oculomotor learning. The improved vergence affected positively on nearwork-related symptoms and visual attention.
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Effect of oculomotor rehabilitation on accommodative responsivity in mild traumatic brain injury
Accommodative dysfunction is a common oculomotor sequelae of mild traumatic brain injury (mTBI). This study evaluated a range of dynamic (objective) and static (subjective) measures of accommodation in 12 nonstrabismic individuals with mTBI and near vision-related symptoms before and after oculomotor training (OMT) and placebo (P) training (6 wk, two sessions per week, 3 h of training each). Following OMT, the dynamics of accommodation improved markedly. Clinically, there was a significant increase in the maximum accommodative amplitude both monocularly and binocularly. In addition, the near vision symptoms reduced along with improved visual attention. None of the measures were found to change significantly following P training. These results provide evidence for a significant positive effect of the accommodatively based OMT on accommodative responsivity. Such improvement is suggestive of oculomotor learning, demonstrating considerable residual brain-visual system plasticity in the adult compromised brain.