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Brain Inj. 2017;31(5):589-600. doi: 10.1080/02699052.2017.1291991. Epub 2017 Apr 25.

The consequence of spatial visual processing dysfunction caused by traumatic brain injury (TBI).

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a Salus University College of Optometry , Philadelphia , PA , USA.
b Padula Institute of Vision Rehabilitation , Guilford , CT , USA.
c Department of Optometry Womack Army Medical Center , Fort Bragg , NC , USA.
d Department of Health Policy and Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
e Department of Ophthalmology , Wilmer Eye Institute, Johns Hopkins Medicine , Baltimore , MD , USA.



A bi-modal visual processing model is supported by research to affect dysfunction following a traumatic brain injury (TBI). TBI causes dysfunction of visual processing affecting binocularity, spatial orientation, posture and balance. Research demonstrates that prescription of prisms influence the plasticity between spatial visual processing and motor-sensory systems improving visual processing and reducing symptoms following a TBI.


The rationale demonstrates that visual processing underlies the functional aspects of binocularity, balance and posture. The bi-modal visual process maintains plasticity for efficiency. Compromise causes Post Trauma Vision Syndrome (PTVS) and Visual Midline Shift Syndrome (VMSS). Rehabilitation through use of lenses, prisms and sectoral occlusion has inter-professional implications in rehabilitation affecting the plasticity of the bi-modal visual process, thereby improving binocularity, spatial orientation, posture and balance Main outcomes: This review provides an opportunity to create a new perspective of the consequences of TBI on visual processing and the symptoms that are often caused by trauma. It also serves to provide a perspective of visual processing dysfunction that has potential for developing new approaches of rehabilitation.


Understanding vision as a bi-modal process facilitates a new perspective of visual processing and the potentials for rehabilitation following a concussion, brain injury or other neurological events.


Vision; cerebrovascular accident (CVA); concussion; egocentre; post trauma vision syndrome (PTVS); prisms; risk of fall (RoF); spatial visual process; traumatic brain injury (TBI); visual midline shift syndrome (VMSS)

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