By Janet Kohtz, FCOVD, NORA
Visual function is often overlooked as part of the rehabilitation effort with Parkinson’s disease. Vision leads the MOVEMENT of the body, an area affected by Parkinson’s. But vision is organized in conjunction with the postural process. A common dysfunction in the vision process is the inability of the peripheral visual process to match information with other somatosensory inputs (eg. kinesthetic, proprioceptive, and the vestibular processes) at the level of the midbrain. Postural control and the coordination of movement are necessary for the maintenance of balance and equilibrium. The correct visual/postural organization is critical for the full range of the visual skills, such as reading, driving, walking and shopping.
The peripheral visual process is preconscious and precedes central visual processing (So we see peripherally without thinking about it). When there is a dysfunction in the peripheral visual system, the central system becomes overstressed and isolational and there is a collapse in the balance between the peripheral and central visual systems. This is called the Post Traumatic Vision Syndrome, and this (PTVS) also causes stress via the autonomic nervous system, such as the shortening of breath, accommodative (focusing) spasms, and increased focalization (an over-attention to central vision). So PTVS is a term used to describe the spatial collapse of the visual process. This research was done initially on head injury patients. Then later it was realized that it included a wide variety of neurological disorders like Parkinson’s disease.
A reduction in the symptoms of Post Trauma Vision Syndrome can be achieved when the visual system comes into better balance. Remediation can be encouraged, under the direction of a Neuro Optometrist, through nasal occlusion (partial occlusion of the lenses close to the nose to open up peripheral awareness), base-in prism (prisms that compress central space and open up peripheral awareness), and the application of balancing prism lenses (base up, down, right, and left, to rebalance the postural structure of the body), and rehabilitation therapy. These tools provide structure for the support of the peripheral visual field, thereby rebalancing the bimodal (central/peripheral) visual process and supporting higher cognitive processing.
PTVS was picked up by Senators Kerry, Obama, and 2 others who wrote it into Senate Bill 1999, with the support of the Blind Veteran’s Organization and the Department of Defense, to develop a program of neuro-optometric rehabilitation for analysis and treatment of wounded warriors. PTVS is also in Congressman Boseman’s Bill 3558. Both Bills were attached to the Wounded Warrior’s Act and were passed.
People with Parkinsons are encouraged to see a neuro optometrist for evaluation and remediation of defective vision anomalies. Learn more at ParkinsonsResource.org/general-information/dr-janet-kohtz/