[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-209154-en":3,"doc-seo-209154-105":31,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":28,"seo_description":14,"update_tm":29,"read_time":30},209154,1099523885336,"Taylor Morgan","https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c",7,"Healthcare","Visuo-Vestibular Rehabilitation for Concussion/mTBI - Part 2","Visuo-Vestibular rehabilitation for concussion/mTBI focuses on how binocular coordination, depth perception, and eye movement control affect functional reading and daily visual efficiency. The material distinguishes strabismic and non-strabismic deficits, explains fixation, saccades, pursuits, and regression demands during skilled reading, and links oculomotor dysfunction to secondary vision syndromes. It also clarifies suppression and diplopia prevention, highlights the need for functional integration with attention, cognitive load, and postural challenges, and outlines visual information processing including spatial, analysis, and visual-motor skills.","Visuo-Vestibular Rehabilitation for Concussion/mTBI  \nPart 2  \nPhoenix Concussion Recovery Lauren Ziaks, PT, DPT, ATC, NCS February 2024  \n[PhoenixConcussion@gmail.com](PhoenixConcussion@gmail.com)  \n1  \nBoth Eyes Need to Work Together  \n• Depth perception: 2 parts required  \n• Stereopsis  \n• Monocular cues to depth  \n• Strabismic deficits: alignment related problem  \n• Non-Strabismic: reading problems, fatigue, eye strain, headaches etc  \n• Effort related problem  \n2  \n\n|  Eye Movement Disorders |  |  |\n| --- | --- | --- |\n|  | Fixation – ability to hold gaze |  |\n|  |  |  |\n|  | Saccades – rapid eye movement between targets |  |\n|  | Pursuits – following target |  |\n|  | Visual scanning – looking in the pantry – must look at the same shelf 4x to find the box of pasta |  |\n|  |  |  |\n\n(c) Lauren Ziaks, PT, DPT, ATC, NCS. 2024  \n3  \nRequirements for reading  \n• Fixation – primary component of reading (duration 200-250msec)  \n• Saccades – take up approx. 10% of reading time,  \n• Regression – right to left movement – 10-20% of the time reading in skilled readers  \n4  \nThe Science of reading  \n• A research lab at the University of Massachusetts, Amherst, investigates what good readers do with their eyes.  \no There is a great (but older) video about reading and eye movements available at: [https://www.youtube.com/watch?v=bSEWrbcrFc0](https://www.youtube.com/watch?v=bSEWrbcrFc0)  \n• Studied adult readers vs early readers  \n• Key findings:  \no Experienced readers require less saccadic regressions  \n▪ Skip ahead on the line more efficiently  \n▪ Able to code the word with less information  \no Early readers:  \n▪ Same patterns as adults but less efficient – more backwards eye movements, more time on each focal point  \n• Point?  \no If you lose your skillset due to a head injury, you will have a harder time with effort, retention, and comprehension and need to relearn!  \n(c) Lauren Ziaks, PT, DPT, ATC, NCS. 2024  \n5  \nOculomotor Dysfunction  \n• Eye movement disorders are common vision deficits secondary to mTBI – “secondary syndromes”  \n• Saccadic dysfunction:  \n• Speed and accuracy of eye movements are reduced vs age expected  \n• Pursuit dysfunction:  \n• Unable to clearly follow a moving object  \n6  \nWhat is suppression?  \n• Suppression used to be thought of as only a permanent condition  \n• In the case of TBI/concussion there is intermittent suppression  \n• Suppression is crucial in malalignment as it prevents diplopia!  \n• As therapists we can INCREASE the severity of suppression by not completing vision therapy correctly  \n• Exercise:  \n• Look at both thumbs – can you appreciate physiologic diplopia in the far field  \n• Telescope  \n(c) Lauren Ziaks, PT, DPT, ATC, NCS. 2024  \n7  \nHow to Put it Together  \nIntegrating your understanding of these definitions with FUNCTIONAL exercises and tasks  \n8  \n• “Effectiveness of the visual system to clearly, efficiently, and comfortably allow an individual to gather visual information at school, work, or play” – Scheiman  \n• Convergence Insufficiency- \\#1 after TBI  \n• Accommodative Insufficiency  \n• Binocular Vision Disorder  \n• “Ability to fuse information from the right and left eyes to form one image – two eyes must be aligned, and the optics must be approximately equal” – Scheiman  \n• Causes diplopia AND/OR suppression  \nRemember – Greatest impairment – Visual Efficiency  \n(c) Lauren Ziaks, PT, DPT, ATC, NCS. 2024  \n9  \nVision isn’t used in a bubble!  \nImportance of divided attention, cognitive loading, and postural challenges  \nDon’t do vision therapy in isolation for concussion!  \nAmbient processing vs focal processing  \nPeripheral awareness exercises  \nFocal processing – the focus point of what you are looking at…High risk of focal binding in concussion  \nAmbient processing – includes vestibular input, shadowing, perspective, size constancy  \n10  \nVisual Information Processing (VIP)  \nNeeded to organize and recognize what we see, integrate the information with our other senses and high-leve","cbCaikOJFBlUCT0P","https://ap.wps.com/l/cbCaikOJFBlUCT0P","pdf",712173,2,1,10,"English","en",105,"# Visuo-Vestibular Rehabilitation for Concussion/mTBI\n## Both Eyes Need to Work Together\n## Eye Movement Disorders\n## Requirements for Reading\n## The Science of Reading\n## Oculomotor Dysfunction\n## What is Suppression?\n## How to Put it Together\n## Effectiveness and Core Vision Constructs\n## Vision Isn’t Used in a Bubble\n## Visual Information Processing (VIP)\n## Visual Spatial Skills\n## Visual Analysis Skills\n## Visual Motor Skills","[{\"question\":\"Why do both eyes need to work together for effective vision after concussion/mTBI?\",\"answer\":\"Binocular coordination supports depth perception and stereopsis, and prevents alignment-related problems that can drive reading difficulty, fatigue, eye strain, and headaches. Visual efficiency is emphasized as the greatest impairment when coordination fails.\"},{\"question\":\"What eye-movement requirements are highlighted for reading?\",\"answer\":\"Reading depends on fixation (reported as 200–250 msec), uses saccades for efficient line traversal (about 10% of reading time), and includes regression movements (right-to-left) in skilled readers estimated at 10–20% of the time.\"},{\"question\":\"What is suppression and how does it relate to diplopia in concussion?\",\"answer\":\"Suppression can be intermittent in TBI/concussion and is described as crucial in malalignment because it prevents diplopia. The material warns that incorrect completion of vision therapy may increase suppression severity.\"}]","Visuo-Vestibular Rehabilitation for Concussion/mTBI - Part 2 | PDF",1788610291,25,{"code":4,"msg":32,"data":33},"ok",{"site_id":25,"language":24,"slug":34,"title":13,"keywords":35,"description":14,"schema_data":36,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":29},"visuo-vestibular-rehabilitation-for-concussionmtbi-part-2","",{"@graph":37,"@context":86},[38,54,69],{"@type":39,"itemListElement":40},"BreadcrumbList",[41,45,48,51],{"item":42,"name":43,"@type":44,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":46,"name":47,"@type":44,"position":20},"https://docshare.wps.com/document/","Document",{"item":49,"name":12,"@type":44,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":44,"position":53},"https://docshare.wps.com/document/visuo-vestibular-rehabilitation-for-concussionmtbi-part-2/209154/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":24,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":42,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-09-11","2026-09-05",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"Why do both eyes need to work together for effective vision after concussion/mTBI?","Question",{"text":76,"@type":77},"Binocular coordination supports depth perception and stereopsis, and prevents alignment-related problems that can drive reading difficulty, fatigue, eye strain, and headaches. Visual efficiency is emphasized as the greatest impairment when coordination fails.","Answer",{"name":79,"@type":74,"acceptedAnswer":80},"What eye-movement requirements are highlighted for reading?",{"text":81,"@type":77},"Reading depends on fixation (reported as 200–250 msec), uses saccades for efficient line traversal (about 10% of reading time), and includes regression movements (right-to-left) in skilled readers estimated at 10–20% of the time.",{"name":83,"@type":74,"acceptedAnswer":84},"What is suppression and how does it relate to diplopia in concussion?",{"text":85,"@type":77},"Suppression can be intermittent in TBI/concussion and is described as crucial in malalignment because it prevents diplopia. The material warns that incorrect completion of vision therapy may increase suppression severity.","https://schema.org",{"og:url":52,"og:type":88,"og:title":13,"og:site_name":59,"og:description":14},"article",{"robots":90,"canonical":52},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":93},[94,98,102,106,111,116,119,124,129,132,135],{"id":21,"doc_module":4,"doc_module_name":47,"category_name":95,"show_sort_weight":96,"slug":97},"Story & Novel",90,"story-novel",{"id":20,"doc_module":4,"doc_module_name":47,"category_name":99,"show_sort_weight":100,"slug":101},"Literature",80,"literature",{"id":53,"doc_module":4,"doc_module_name":47,"category_name":103,"show_sort_weight":104,"slug":105},"Exam",70,"exam",{"id":107,"doc_module":4,"doc_module_name":47,"category_name":108,"show_sort_weight":109,"slug":110},5,"Comic",60,"comic",{"id":112,"doc_module":4,"doc_module_name":47,"category_name":113,"show_sort_weight":114,"slug":115},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":47,"category_name":12,"show_sort_weight":117,"slug":118},40,"healthcare",{"id":120,"doc_module":4,"doc_module_name":47,"category_name":121,"show_sort_weight":122,"slug":123},8,"Research & Report",30,"research-report",{"id":125,"doc_module":4,"doc_module_name":47,"category_name":126,"show_sort_weight":127,"slug":128},9,"Religion & Spirituality",20,"religion-spirituality",{"id":127,"doc_module":4,"doc_module_name":47,"category_name":130,"show_sort_weight":127,"slug":131},"World Cup","world-cup",{"id":22,"doc_module":4,"doc_module_name":47,"category_name":133,"show_sort_weight":22,"slug":134},"Lifestyle","lifestyle",{"id":136,"doc_module":4,"doc_module_name":47,"category_name":137,"show_sort_weight":107,"slug":138},19,"General","general"]