Post Trauma Vision Syndrome (PTVS)

In PTVS, the spatial visual process loses its ability to organize spatial information. When this occurs, the affected person becomes “focally bound”, or overly fixated on visual details, and has to work harder to use their vision. The extreme effort and intensity required to use the focal visual process leads to visual fatigue, headaches, and eyestrain.

PTVS can also cause individuals to visually isolate on single letters in a word instead of full words when reading, producing difficulty in “releasing” or moving their vision away from letters and words. This can cause words to appear to jump and move around the page as the person attempts to read. It can also cause intermittent blurring and even double vision.

Some individuals with PTVS find it more difficult to function in busy/crowded environments such as supermarkets or shopping malls. They can unconsciously identify people walking around in their peripheral vision as detail which becomes confusing and stressful. In some cases, those with severe dysfunction of the focal and spatial visual process will become anxious and may even develop an anxiety disorder due to the way their visual world is re-ordered.

Symptoms of PTVS include:

• Double vision
• Headaches
• Blurred vision
• Dizziness or nausea
• Attention or concentration difficulties
• Staring behavior (infrequent blinking)
• Spatial disorientation
• Losing your place when reading
• Not being able to find the beginning of the next line when reading
• Visual memory problems
• Pulling away from objects when they are brought close to you
• Seeing objects as moving when they are actually stationary

Difficulty tolerating busy/crowded environments

Here at the Padula Institute of Vision, we are committed to providing you with rehabilitative services that help bring balance back to the two visual processes (focal and spatial) and improve your quality of life. Many symptoms of PTVS are unrelated to the overall health of your eyes which makes them easy to miss during a traditional eye exam. This is where we step in to provide our expertise and assist with your rehabilitation through special testing using Visual Evoked Potentials (brainwave tests).

Visual Midline Shift Syndrome (VMSS)

Our spatial vision and motor systems work together to establish where the midlines of our bodies are in space from information from our muscles and joints. If you imagine an invisible line drawn down the center of your body from head to toe, this provides an example of one of the many midlines that exist in your body without conscious thought. Generally you have an understanding of where your midline is, both front to back and from right to left without thinking about it. But if either your spatial vision or your motor system is impaired, your sense of midline may be shifted in one or many directions, distorting your sense of space. This results in Visual
Midline Shift Syndrome (VMSS).

This perceived distortion of space can affect posture when walking, standing, and sitting. It can result in a lean and/or ‘drift’ to one side when walking which can impact balance and increase your risk of fall or serious injury. It is also possible to experience back pain or muscle rigidity as a result of VMSS.

Symptoms of VMSS include:

• Dizziness or nausea
• Spatial disorientation
• Consistently drifting to one side of hallway or room
• Bumping into objects when walking
• Poor balance or posture (leaning forward, backward or to one side when walking, standing or seated in a wheelchair)
• Back pain or muscle rigidity

Difficulty tolerating busy/crowded environments

Through observation of someone walking, it is possible to observe changes in posture and weight shift. Here at the Padula Institute of Vision, we combine gait testing with our keen observational skills to evaluate our patients for VMSS and provide avenues for rehabilitation.