A vital part of your overall recovery

Brain injury from a traumatic event like a concussion, or medical condition such as stroke or other neurological disease often impacts daily function.

Vision problems may be overlooked during initial evaluation as symptoms may not be present until days or even weeks following the incident. Therefore, visual deficits related to traumatic brain injury and other neurological disorders should be evaluated by a Neuro-Optometric Rehabilitation Optometrist, a doctor who has special expertise in the assessment and treatment of visual disturbances associated with damage to the central nervous system.


Acquired Brain Injury (ABI) is an all-encompassing term for damage to the brain. ABI can have a profound effect on activities of daily living. Some commonly reported symptoms include visual disorders, speech impairments and general motor dysfunction.

An ABI can be the result of a medical condition such as stroke, tumor, aneurism, meningitis, multiple sclerosis, cerebral palsy, or other neurological disease. Traumatic Brain Injury (TBI) is also a common example of ABI. It is caused by an external force, such as a blow or jolt to the head that disrupts the function of the brain.

According to the U.S. Centers for Disease Control and Prevention, falls are the leading causes of TBIs in the United States, followed by being struck by an object, along with motor vehicle accidents. Sports and recreational activities also contribute to many traumatic brain injuries among people of all ages. Although some sports have higher instances of concussion — such as football, ice hockey, and soccer — concussions can happen in any sport or recreational activity.

There is often an interruption in communication between the eyes and the brain following a TBI. Studies show that 90 percent of TBI patients suffer from visual dysfunctions such as those shown below. Following a stroke, there are often problems with eye tracking and/or peripheral vision, which can affect mobility, balance, and tasks such as reading.

Vision problems that are left untreated can have serious consequences. If you notice any changes in your vision following a head injury or due to any neurological medical condition, don’t ignore them and seek evaluation by a Neuro-Optometric Rehabilitation Optometrist.


Neuro-optometric rehabilitation is an individualized treatment regimen for patients with visual disorders related to developmental syndromes, stroke, brain injury and neurodegenerative disease. Optometrists skilled in Neuro-Optometric Rehabilitation Therapy have pursued extended education and training, emphasizing the use of specially designed lenses, prisms, and vision therapy rehabilitation regimens.

During an examination, a Neuro-Optometric Rehabilitation Optometrist will examine complex aspects of the visual process. Included are tests for ocular movements and coordination, posture, spatial awareness, integration with other sensory systems such as the vestibular system (the parts of the inner ear and brain that help control balance and eye movements), visual memory, and motor output (a muscle, nerve or center that effects movement). Since every injury is unique, the treatment plan strategy is customized to the individual’s needs. Clinical experience and research studies document the improved performance of patients who have completed a vision rehabilitation program.

Often one type of rehabilitation is not enough to address all of an individual’s need. An interdisciplinary, integrated team approach can play a vital role in the rehabilitation of patients with concussions, stroke or other neurological disorders. In addition to optometrists, rehabilitation team members may include nurses, physical and occupational therapists, speech-language pathologists, physical medicine and rehab physicians, neurologists, neuropsychologists, audiologists, ophthalmologists, and others.

For more information about Neuro-Optometric Rehabilitation, including where to find a Neuro-Optometric Rehabilitation Optometrist near you, visit www.noravisionrehab.org

In Singapore, Dr Yap Tiong Peng is a member of the Neuro-Optometric Rehabilitation Association, International, and he is the first person in Singapore to be board certified in Vision Therapy. Dr Yap holds Triple Clinical Fellowships (FAAO, FACBO and FCOVD) and strives to provide the highest standards and level of care to patients.

Dr Yap Tiong Peng and the team at IGARD Vision Therapy (Singapore) provides vision therapy and neuro-optometric visual rehabilitation.


The Neuro-Optometric Rehabilitation AssociationTM, International (NORA) is an inter-disciplinary group of professionals dedicated to providing patients who have physical or cognitive disabilities as a result of an acquired brain injury with a complete ocular health evaluation and optimum visual rehabilitation education and services to improve their quality of life. NORA is committed to advancing the art and science of rehabilitation, with particular emphasis on treatment modalities designed to optimize visual-motor, visual-perceptual and visual information processing dysfunction among neurologically affected persons.

October 2023: Hot off the press!

Do you know what are Ocular Motor Disorders? These are problems with eye movements and visual focusing that can hinder reading, reduce attention span, and contributes to the visual discomfort, eyestrain, visual stress, and many other symptoms, such as dizziness, headaches and light sensitivity.

Many of these issues can occur after a concussion or mild traumatic brain injury; neuro visual rehabilitation and vision therapy can help! In Singapore, vision therapy is available at IGARD. “Together with a team in the US, we have published the protocol of our upcoming scoping review on ocular motor disorders in concussion / mild traumatic brain injuries on the British Medical Journal (Open access)”, said Dr Yap Tiong Peng who is a Senior Consultant at IGARD.

Their work is supported by Cochrane Eye and Vision and the American Academy of Optometry. Based in Singapore, Dr Yap is the only member of the team who is located outside of the United States, and the team has already completed the screening of 14,000 abstracts. “I am humbled to be part of this amazing team of brilliant optometrists and academics in the United States, and I am looking forward to adding to the evidence base in the treatment of vision problems related to concussion”, he said.

Theis J, Chen AM, Burgher AP, Greenspan LD, Morgenstern A, Salzano AD, Yap TP, Scheiman M, Roberts TL. Ocular motor disorders in children and adults with mTBI: a scoping review protocol BMJ Open 2023;13:e073656. doi: 10.1136/bmjopen-2023-073656