Published Academic Articles
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Published Academic Articles
/ / / Identification of Binocular Vision Dysfunction (Vertical Heterophoria) in Traumatic Brain Injury Patients and Effects of Individualized Prismatic Spectacle Lenses in the Treatment of Postconcussive Symptoms: A Retrospective AnalysisIdentification of Binocular Vision Dysfunction (Vertical Heterophoria) in Traumatic Brain Injury Patients and Effects of Individualized Prismatic Spectacle Lenses in the Treatment of Postconcussive Symptoms: A Retrospective Analysis
INTRODUCTION
It is not uncommon for patients with traumatic brain injury (TBI) to experience cephalgia and neck ache, as well as difficulty with balance, impaired coordination, ambulation problems, anxiety, and vision abnormalities attributable to their TBI [1]. These symptoms can persist even after the patient participates in a prolonged and extensive rehabilitation course. To date, a single unifying cause of these symptoms has not been identified. Vertical heterophoria (VH), a form of binocular vision dysfunction, is associated with a set of symptoms that overlaps significantly with the symptoms associated with TBI (Table 1). At present, an association between VH and TBI is lacking. Serendipitously, a patient experienced a marked reduction in presumed postconcussive symptoms after treatment by one of the authors (D.L.F.). Given this positive experience, additional patients were evaluated and treated, with similar results. It is this anecdotal experience that prompted this retrospective analysis and report.
CONCLUSION
Results: There was a 71.8% decrease in subjective symptom burden when compared with the preintervention baseline. There was a mean 16.7-point absolute reduction in the VHS-Q score on a 75-point scale, which represents a relative reduction in VHS-Q score of 48.1%.
Conclusions: Vertical heterophoria was identified in a group of TBI patients with postconcussive symptoms and treatment of the vertical heterophoria with individualized prismatic spectacle lenses resulted in a 71.8% decrease in subjective symptom burden and a relative reduction in VHS-Q score of 48.1%. It appears that vertical heterophoria can be acquired from TBI.
Keywords: TBI, binocular vision dysfunction, dizziness, headache, micro-prism, vertical heterophoria
Published in: PM & R | Volume 2, 244-253, April 2010
Read the full research paper with figures (PDF)
Authors: Jennifer E. Doble, MD, Debby L. Feinberg, OD, Mark S. Rosner, MD, Arthur J. Rosner, MD
Published in:PM&R | Volume 2, 244-253, April 2010
Poster presentation at: The Anxiety Disorders of America Annual Meeting, Arlington, VA, April 2012
Poster presentation at: The American Headache Society 54th Annual Scientific Meeting, Los Angeles, CA, June 2012
Poster presentation at: The American Academy of Otolaryngology – Head and Neck Surgeons Annual Meeting, September 2012
Posted in: Otology and Neurotology, January 2020
Authors: Debby L. Feinberg, OD, Mark S. Rosner, MD, Arthur J. Rosner, MD
Published in:Future Science | 2022 | FSO813
Authors: Cherylea J Browne, Paul Fahey, Stella R Sheeba, Margie H Sharpe, Mark Rosner, Debby Feinberg & Viviana Mucci
Published in:PM&R | Volume 2, 244-253, April 2010
Authors: Jennifer E. Doble, MD, Debby L. Feinberg, OD, Mark S. Rosner, MD, Arthur J. Rosner, MD
Published in: Optometry & Visual Performance | Volume 8 | Issue 1 | 2020, March
Authors: Debby L. Feinberg, Mark S. Rosner, Arthur J. Rosner
Posted presentation at: The American Academy of Optometry Annual meeting, November 10, 2016
Authors: Debby L. Feinberg, Mark S. Rosner, Arthur J. Rosner
Posted online:February 1, 2020, Vestibular Disorders Association (VEDA).
Authors: Debby L. Feinberg, Mark S. Rosner
Poster presentation at: The 9th World Congress on Brain Injury, Edinburgh, Scotland March 2012
Poster presentation at: The Anxiety Disorders of America Annual Meeting, Arlington, VA, April 2012
Authors: Mark S. Rosner, Debby L. Feinberg, Jennifer E. Doble & Arthur J. Rosner
Published in: The journal Brain Injury, February 2016.
Authors: Debby L. Feinberg, Mark S. Rosner
Published online: November 2, 2016, Vestibular Disorders Association (VEDA).
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Dr. Sandy DiPonio earned her optometry degree from Illinois College of Optometry in 1996. She is a highly skilled and experienced eye care professional dedicated to giving her patients of all ages excellent and compassionate care. She has a wide variety of experience in binocular vision, pediatric and adult eye care, ocular disease and contact lens fitting. She strives to provide each of her patients the best quality of life they can achieve with their vision through knowledge and education of treatment options.
Dr. DiPonio is a member of the American Optometric Society and Michigan Optometric Society.
Dr. Sally Hoey has been practicing optometry since graduating from Michigan College of Optometry in 2001. During her time in optometry school, she developed an interest in binocular vision, culminating in a senior thesis involving binocular vision.
Prior to joining Vision Specialists of Michigan, Dr. Hoey specialized in the diagnosis and treatment of vision-related learning problems as well as other binocular vision disorders. Her other areas of interest include specialty contact lens fittings and treating dry eye. Dr. Hoey strives to provide her patients with clear, comfortable vision while meeting their individual needs at the same time.
Dr. Hoey had the opportunity to provide eye care on an optometric mission trip to Guyana, South America and vision screenings at a local medical clinic. She is a member of the American Optometric Association, Michigan Optometric Association, Metropolitan Detroit Optometric Society and the College of Optometrists in Vision Development.
Dr. Jennifer Place graduated with honors from Michigan College of Optometry in 2001.
Before joining Vision Specialists of Michigan, she specialized in treating pediatric and adult patients with binocular vision disorders and vision-related learning problems, as well as fitting specialty contact lenses and managing various types of ocular disease. She enjoys working with patients with unique visual needs, and she takes great pride in providing all patients with highly customized care.
Dr. Place has volunteered for Opening Eyes, a program that provides eye exams to the athletes of the Michigan Special Olympics, and she participated in an international mission to St. Lucia to provide eye care to those in need. Dr. Place is a member of the Detroit Optometric Society, the Michigan Optometric Association, the American Optometric Association, the College of Vision Development, and the Optometric Extension Program Foundation.
Dr. Mary Jo Ference has been practicing optometry since 1990 upon graduating from Ferris State University- Michigan College of Optometry, and is certified in Low Vision Rehabilitation. She has worked at Sinai-Grace Hospital systems for over 20 years before joining Vision Specialists of Michigan in 2013 to work with binocular vision disorders. Her clinical areas of expertise include visual rehabilitation of pediatric and adult patients who have suffered from brain trauma, injury or disease. She has taught both optometry and ophthalmology residents at Sinai Grace Hospital. Dr. Ference has sat on numerous boards, including Sinai Grace Hospital, Berry Out-Patient Surgical Center, and Seedlings Braille Books for the Blind. She is actively involved in area school districts to provide education, training and access for students, teachers, OT’s and PT’s to eye care service rehabilitation information. Dr. Ference has lectured extensively nationally and internationally.
Dr. Debby Feinberg began practicing Optometry in Oakland County in 1983, upon graduating from Illinois College of Optometry. She joined her father, Dr. Paul C. Feinberg, at Mall Optical Center, which was located in Summit Place Mall.
Since 1995 Dr. Feinberg has been developing the field of NeuroVisual Medicine which is the optometric subspecialty that identifies and treats neurological / medical symptoms that originate directly or indirectly in the visual system.
Dr. Feinberg has been performing pioneering work with Binocular Vision Dysfunction (BVD), a condition where a vision misalignment (frequently subtle) creates difficulties with the two eyes working together to create a single 3-dimensional image, and difficulties with the two eyes following that image as it moves.
The symptoms caused by BVD are not usually associated with problems with the visual system, and include headache, dizziness, anxiety and panic, persistent post-concussive symptoms, gait instability and balance problems, frequent falls, neck pain, motion sickness, nausea, and reading and learning problems.
In 2004. Dr. Feinberg established Vision Specialists of Birmingham, specifically designing the practice to accommodate the needs of the NeuroVisual Medicine patient.
In 2011, the office moved to its current location in Bloomfield Hills and updated its name to Vision Specialists of Michigan.