Remediation of Visual Snow (VS) and Related Phenomena in a Neuro-Optometric Practice: A Retrospective Analysis
Barry Tannen, OD, FCOVD, FAAO Jacob Brown, OD Kenneth J. Ciuffreda, OD, PhD, FCOVD, FAAO, FARVO Noah M. Tannen, OD, FCOVD, FAAO
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This is the first paper to demonstrate successful neuro-optometric rehabilitation (NOR) in a clinical population diagnosed with VSS and its wide array of unique visual symptoms. It included the use of: (1) chromatic tints/filters to reduce the perceived intensity and frequency of the VS and many of the other abnormal visual phenomena (e.g., palinopsia)reported in those with VSS; these filters reduce the overall illumination of the visual field, more so in the specific “offensive” spectral band, which typically appears to be in the blue region of the visible spectrum.14 (2) Saccadic tracking to reduce the perceived intensity and frequency of the palinopsia, which has been speculated to occur due to a disinhibition/ hypersensitivity phenomenon related to saccadic suppression;6,7 the training appears to reestablish/reset a more normal level of saccadic suppression, such that its smeared, afterimage perception during a saccade is inhibited once again. In addition, and somewhat serendipitously, this is the first study to detect, diagnose, and treat the multitude of versional oculomotor deficits (i.e., OMD) that appear to be present with a very high frequency of occurrence in our sample (~60%), and likely present more generally.15,16 This is fruitful territory for future investigations (see later Discussion). We have found that common optometric diagnostic tests (DEM, Visagraph, and direct observation of eye movements) combine to allow for the diagnosis of oculomotor dysfunction.