Vision impairment appears often in people with Parkinson’s, but perhaps more particularly in people with Parkinsonisms, such as PSP. There are very few Neuro-Optometric Rehabilitation/Habilitation doctors in the United States that understand vision and neuro-degenerative diseases.

Disturbances of various visual systems manifest with many symptoms and/or behaviors. Patients who have been diagnosed with strokes, seizures, autism, brain injury, genetic diseases, processing problems or neuro-degenerative diseases may have subtle visual system dysfunctions. Neuro-optometric rehabilitation addresses those dysfunctions.

20/20 isn’t enough. Changing input into the eyes changes brain functions, which in turn affects body systems.

All body systems are connected and interdependent.

Neuro-optometric rehabilitation assesses the ability to adapt to changes in the environment, while emphasizing perceptual awareness and attention used in executive functions.

Below is a checklist to assist rehabilitation professionals (doctors, therapists, counselors, etc.) in determining the appropriateness of referring clients for neuro-optometric rehabilitation and treatment.


Eyesight Comfort Spatial Judgments

• focusing • dry eye • walking

• aiming (double vision) • visual perception • depth perception

• clarity (visual acuity) • vertigo • visual midline shift

• visual field loss


• Balance – Vision plays a significant role in balance. Approximately twenty percent of the nerve fibers from the eyes interact with the vestibular system. There are a variety of visual dysfunctions that can cause, or associate with dizziness and balance problems. Sometimes these are purely visual problems, and sometimes they are caused from other disorders such as stroke, head injury, vestibular dysfunction, deconditioning, and decompensation.

• PTVS – Post Trauma Vision Syndrome

• Post Concussive Syndrome

• Dizziness

• Eye Movements

• Paresis & Paralysis – Neurologists use the term paresis to describe weakness, and plegia to describe paralysis in which all voluntary movement is lost.

• Nystagmus – A vision condition in which the eyes make repetitive, uncontrolled movements. These movements often result in reduced vision and depth perception and can affect balance and coordination. These involuntary eye movements can occur from side to side, up and down, or in a circular pattern

• Convergence Insufficiency

The treatment plan improves specific acquired vision dysfunctions determined by standardized diagnostic criteria. Treatment regimens encompass medically necessary non-compensatory lenses and prisms with and without occlusion and other appropriate rehabilitation. Behavioral observations during therapy sessions or medical examination, in-depth interviews and screening will provide information to rehabilitation professionals about potential visual and neuro-motor dysfunction.

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