Oculomotor rehabilitation in acquired brain injury: a case series

OBJECTIVE: To investigate the effects of systematic, oculomotor rehabilitation on basic versional ocular motility, as well as reading eye movements, in subjects with acquired brain injury, using objective eye movement recording and subjective rating of reading ability. DESIGN: Case series. SETTING: Clinical research laboratory. PARTICIPANTS: Two men with acquired brain injury: one with traumatic brain injury and one with stroke. INTERVENTIONS: Versional oculomotor training was performed for 1 hour, twice weekly for 8 weeks. There were 2 feedback modes of training: normal internal oculomotor visual feedback alone (4wk), or that feedback in conjunction with external oculomotor auditory feedback (4wk). Testing was conducted before and after training.Main outcome measures Objective outcome measures included both basic eye movement parameters (fixational accuracy, saccadic gain and latency, pursuit gain, mean saccade frequency ratio for simulated reading), and reading eye movement parameters (words per minute, grade level equivalent, fixations per 100 words, regressions per 100 words, percentage of reading comprehension, duration of fixation in seconds). Subjective outcome measures included the subject's ability to read based on the responses to the reading rating-scale questionnaire. RESULTS: Both subjects improved objectively in terms of basic versional oculomotor accuracy and reading ability. These findings concurred with their subjective impressions. CONCLUSIONS: This case series provides objective documentation of the positive effects of oculomotor rehabilitation on basic ocular motility and reading ability in selected cases with acquired brain injury, thus suggesting the need for a larger clinical trial in this area.