Behavioural Optometry: I had a TBI two years ago at... - Headway

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Behavioural Optometry

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I had a TBI two years ago at work causing a subdural Haematoma, midline shift and a stroke as well as the effects of your brain being compressed.

The fog in my head has slowly begun to lift and allow me to reflect on the changes that have happened over that time.

One of many things that I now encounter is veering to the left when I walk. When walking along a pavement I find that even though I concentrate I veer to the left and have to constantly look down and correct my self.

In a recent assessment I was told surprisingly that it is very likely to be imbalance in my eyesight and that I should seek the advice and therapy of a Behavioural Optometrist.

Does anyone have experience of this condition or treatment for this? I have an Optometrist near to me, the only behavioural optometrist in my area but they are really expensive and I would be funding it myself.

Thanks

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34 Replies
Kirk5w7 profile image
Kirk5w7

Hi

Funny this. I veer to the right and was told it could be inner ear problem. Still waiting ENT appointment after 2 years.🤦‍♀️

in reply to Kirk5w7

Thanks for that. As part of litigation I had an Immediate Needs Assessment carried out on me. Amonst other things, the assessors experience she said that it was a common thing for people who have had a TBI to veer to one side when walking.

Her experience was the reason why I was to be sent to the Behavioural Optometrist. Research on the web site for this specialism seems to confirm to me that they are the best course of action for me. I was quoted £450 for the initial 2 hour assessment and just wondered about any other persons experiences before I spent this money.

My litigation could rumble on for some time and I am anxious to get some rehab.

pinkvision profile image
pinkvision

Hi Chris, I've had both visual processing issues and veering to the left. I saw an optometrist to get most of my visual symptoms sorted. However these had nothing to do with the veering which was corrected by cranial/ vestibular/ ocular exercises. Apparently retraining the cervical/ vestibular/ ocular reflexes also helps the cerebellum reorganize. This is the part of the brain that stores spatial awareness information.

I suppose it would be a good idea to get tested because the visual system is part of the cervical/ vestibular/ OCULAR reflex.

But we are all different and the root causes may also be different. If the optometry helps that's great but if it does not you can rule it out and narrow down your search.

Here's an idea for you, go to your GP and ask if the health authority would pay for optometry tests at the Cardiff university opticians because they provide optometry services too. The university has an optometry school where optometrists are trained. They accept NHS patients, but your health authority may have to pay. However if they won't pay, the private costs are really low compared to independent providers.

Here's a link

cardiff.ac.uk/optometrists

Phone them and ask about their specialist services, they will give you the price.

Show the link to your GP.

If you live in London the South Maudsley Health authority provides optometry testing on the NHS. It's an experimental service. You'll have to contact them to find out about it.

I've also heard that there is an NHS service in Essex but I can't remember what the details are.

Cardiff seems the best bet because they already advertise the service. I also think that if you allow a student to do the testing (they are under supervision) it may be free of charge.

in reply to pinkvision

Wow! that is fantastic information about Cardiff. I live near to York but it would be worth the travel if they can do something for me. I do have a Behavioural Optometrist at York who is very well respected in the field but it is the £450 for an assessment. That made me ask this question. I will post an update when I have one. Thanks again both of you for the information.

pinkvision profile image
pinkvision in reply to

No Probs, have shared this information for years on this site and as far as I know no one has ever followed it up.

I think it's weird that people have visual issues after a brain injury and because the NHS don't provide optometry services, they begrudge having to pay a few hundred quid for private testing. I share the information about Cardiff and still no one goes.

What's that all about?

I paid to go private, best money I ever spent because it kickstarted my recovery and now I've more or less got all my functions back except a few sensory processing issues and spinal issues.

I've found that health and wellbeing is far more valuable than bits of paper with the Queen's or King's head on or numbers in a bank account.

TreesMTBI profile image
TreesMTBI in reply to

Chris I’m not far from York and know who you’re talking about. I too baulked at the price and it made me rethink everything and think of alternatives. I’ve got my GP on board trying to find a solution …. I’m liking PV’s suggestions re Cardiff very much!

Writeronstack profile image
Writeronstack in reply to

Leeds hospital also have an optometry department who are amenable to being contacted via your GP for assessement and treatment.

I looked them up for you - here they are:

leedsth.nhs.uk/services/opt...

TreesMTBI profile image
TreesMTBI in reply to Writeronstack

Oh my goodness, thanks for this W-onstack!

Tx

Writeronstack profile image
Writeronstack in reply to TreesMTBI

I think the optometrist who referred me to the eye hospital came from Leeds. That's why I knew. She knew about the specialisms of Oxford, and that they would be able to help me. My eye problems were more actual eye related rather than brain. But the injury had upset the eye. The bang on the head was quite close to it.

TreesMTBI profile image
TreesMTBI in reply to pinkvision

Hi PV thanks as ever - I’ve got my GP onboard about the vision therapy and she is finding out about referral (which I already knew would draw a blank in my area 😂) but wanted to know how my practice’s referral team would handle it as they are quite resourceful I think. I hadn’t thought to implement your suggestion to request the health authority pay for testing at Cardiff but maybe I was lining myself up to request that after I read your suggestion on here today 😂 helping out my future self. (Jeez, pre-accident I would have been finding any way to get this done, like trying your suggestion but can’t seem to join up the dots or it takes me weeks or month or years to get there!).

Thanks again PV, headway should give you an award for being top/most helpful contributor or something 😃

Tx

pinkvision profile image
pinkvision in reply to TreesMTBI

Maybe you should tell them! 😉

I recently contacted my regional Headway person and offered FREE advice and rehab sessions for PCS/ TBI. I guess you know I went to uni to do a masters research degree and developed a rehab program. I also did the teacher training and the specialist skills training tickets and have been registered and insured as an alternative rehab provider.

Business Wales were providing mentorship to develop this as a medical application and had grants available but in 2023 the funding was cut for new startups and they pulled the plug.

So I decided to try and develop it as a YouTube channel. The prototype is up and running. It looks like another government body may provide a small grant to get it looking more professional. They are interested to find out whether people would watch and do some rehab themselves because that's the way the health system is looking to go. I.e. access your rehab online rather than waiting for years for non-existent one to one.

Anyway I'm trying to put all this info online so anyone around the world can access it.

Check it out, let me know what you think (remember it's still a prototype done on a shoestring)

youtube.com/@mendingbrokenb...

TreesMTBI profile image
TreesMTBI in reply to pinkvision

Yes, thanks PV, I went to look then realised I'm already following your YT site :D that's a good start! I am making it a priority to go through your videos now, as I'm in between lots of referrals (*sigh*) so this will be good for me - and maybe I won't need some/all of the referrals after all?! I'll keep in touch with you. Thanks again.

Tx

pinkvision profile image
pinkvision in reply to TreesMTBI

Did you see the comment that Writer wrote about Leeds providing Optometry services by private providers. Letting you know in case you have not.

Leaf100 profile image
Leaf100

Hi ChrisI used to veer. When I tried to walk from a to b I ended up at c. Then I started talking like a sailboat.

I did not know of any of the things Pink Vision has told you about and suggested.

I had tried vestibular therapy - which made everything worse.

What I did was to use a walker. I got feedback right away when I was starting to fall over or veer. It took awhile , but eventually I could go from a to b direct.

I do have some remaining visual issues and I understand a neuro optometrist might or might not help. I did go for an estimate and it was 4000 Canadian. (I am in Canada.) That's about 2200 GBP. Too much for something that is not guaranteed.

The other thing I was assessed for by optometrist was the need for prisms in my eye glasses. This is a more reasonable cost. Luckily I didn't need them. People I know who do need them and got them saybit made a huge difference.

Keep us posted.

Leaf

in reply to Leaf100

Thank Leaf. I think that the cost privately is what is holding me up. Along with the uncertainty of not knowing if it going to work.

I have started to use a tread mill for an hour three times a week. This helps reduce my blood pressure 180/90 down to 135/75 and boost the feel good hormones.

Another benefit is the testosterone boost 😉

I use the tread mill for the fact that if I veer or wobble that I dont have the usual problems associated with cars, kids, animals or the weather getting in the way. It does seem to temporarily improve the balance after I get in a rhythm after around 20 mins walking.

TBI_Friday profile image
TBI_Friday

I had subdural haematoma, subarachnoid haemorrhage and parenchymal haemorrhage in2022, multiple symptoms of all kinds of crazy stuff..I don't really veer off left or right noticeably but I did suffer from BPPV (now treated), but I do find myself still bumping into things when walking, mis-judging doorways, banging into walls when turning around and quite clumsy using my hands dropping things etc. probably not the same thing but I'd be quite keen to learn how to fix it

TreesMTBI profile image
TreesMTBI in reply to TBI_Friday

Hi T_F

I’m 7 years post mTBI and still dealing with several symptoms. I’ve had vestibular things on and off and currently dealing with BPPV (according to the GP). I’m interested - how did you get that treated? A vestibular physio has recommended I go for vision therapy - just working on making that happen somehow and PV’s recommendations have helped in that process…

pinkvision profile image
pinkvision in reply to TreesMTBI

Hi Trees, the problem with the NHS is that everything is broken up. Vision therapy in conjunction with vestibular therapy is the way ahead, not as separate things but done together. These systems are all controlled by the cranial nerves.

I've made a video explaining this and have demonstrated a few ways to improve your symptoms.

youtube.com/watch?v=tztOpWw...

TreesMTBI profile image
TreesMTBI in reply to pinkvision

Wouldn't it be great to have a joined-up, comprehensive, all encompassing rehab service for all patients on the wide-ranging spectrum of brain injury.... I suppose people in little pockets are trying to make it happen here and there. The demands on all areas of the NHS are immense, as research progresses into different fields, it must be difficult on those who make decisions on what to prioritise.

TreesMTBI profile image
TreesMTBI in reply to pinkvision

PS I can't get the video to work. Is this on your youtube site PV?

pinkvision profile image
pinkvision in reply to TreesMTBI

Yep - youtube.com/@mendingbrokenb...

TBI_Friday profile image
TBI_Friday in reply to TreesMTBI

Sorry for the late reply, I complained to my employer that I kept bumping into things, fall over, lose balance and go extremely dizzy depending on my body position. They sent me to DMRC Stanford Hall to be tested and they confirmed it was bppv. They taught me the epley manoeuvre and it cleared up after a month or so. There are other manoeuvres to try too, there will definitely be videos on YouTube 👍

TreesMTBI profile image
TreesMTBI in reply to TBI_Friday

Thanks, pretty much what I've been shown/given, interested to see what other folk's treatment has been and if I'm missing anything :)

pinkvision profile image
pinkvision in reply to TreesMTBI

The epley maneuver 'swishes' the octonia back into the vestibular canals. You can do the same thing by doing repetitive exercises on the three planes corresponding to the canal directions, ie up and down, rotating from side to side horizontally and side to side vertically.

Once the octonia are back in the canals it takes a great deal of rapid force, ie a head injury, to knock them back out again.

There's examples of exercises on the youtube channel for multiple cranial nerve problems including eye movements (some call it visual therapy and charge mega bucks, do it yourself and save money).

lcd8 profile image
lcd8

Hi everyone. This discussion is so interesting and I just wanted to thank you all for sharing. I have a congenital TBI, an AVM in (yes you've guessed it) the cerebellum. I have always been uncoordinated and clumsy and I know its down to this. But as I'm getting older I'm also getting more conscious that I can't walk straight and veer to the left.

pinkvision profile image
pinkvision in reply to lcd8

A congenital AVM means you were born with a tangle of blocked blood vessels in the cerebellum. Is that right?

lcd8 profile image
lcd8 in reply to pinkvision

Yep thats right. Also have recurrent hydrocephalus as a result!

pinkvision profile image
pinkvision in reply to lcd8

Have you come across Barbara Arrowsmith-Young. She wrote 'The woman Who Changed Her Brain.' In the book she describes her life with a congenital brain disorder and then she figured out how to change her brain using neuroplasticity techniques. Then she founded the 'The Arrowsmith Program' it's based in Canada.

The techniques used involve doing the things you 'can't do.' her program does not involve physical/ spatial awareness things but the same principle would apply to congenital conditions.

This means that if you practice to walk in a straight line every day for a number of months your brain will adapt to walking in a straight line. It's the nature of neuroplasticity.

Same goes for TBI but it's a bit more complicated and involves unknowns in the sensory, body regulatory, emotional and cognitive domains and it needs to be done in a particular order.

Check out Barbara online.

Writeronstack profile image
Writeronstack in reply to pinkvision

Barbara Arrowsmith-Young's book was truly inspirational. I read it at your behest. Thank you.

lcd8 profile image
lcd8 in reply to pinkvision

Many thanks. Sounds like that would definitely be worth a read.

APAscot profile image
APAscot in reply to lcd8

same with me but wouldn’t have associated it with my AVM, which spontaneously thrombosed in 2016 but that’s another story. My granddaughter finds it hilarious that I can’t walk straight. I bump into every door frame and other immovable objects (just getting over a broken toe). Being on warfarin paints a pretty picture and doesn’t help so can’t wear anything that shows my legs. Mind you at my age ………! This is all brilliant information even though most of it doesn’t relate to me. Love this site.

Teazymaid profile image
Teazymaid

I have the same problem and have now started to see a balance physio. . I have to pay private as they are not available in the NHS in Cornwall . It is to do with balance and the inner ear .. I’m amazed at the tests she did on me and the 1st appointment was an 1 1/2 hours well work every penny and lots of exercise to improve my balance .. I can only walk looking at the floor in front of me and also I walk to the right Sue 😊

I have just started using hacking sticks with large rubber feet in the metal point .. this is slowly beginning to help as I’m trying to walk looking down the road and around me , so I am gobsmacked how different it is when outside and elevate the pain in my neck from constantly looking at the floor in front of me 😊

Jodieb73 profile image
Jodieb73

sounds like my story I used to go left depending on which side of your brain was injured can effect your ability to move forward mine was my right effecting the left side I’m sure you should not have to fund that yourself contact headway in your area for the right information there very understanding and helpful

Hope you get some answers

pinkvision profile image
pinkvision

Hi Chris just checking to see if you have seen Writer on Stack's comment about Leeds NHS providing optometry services from independent providers. It's closer and may be a better option than Cardiff.

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