(Original article from Insight)
Visual snow syndrome (VSS) is a newly recognised syndrome. It has been characterised by persistent visual disturbances resembling static, akin to the noise of an untuned analog television, as well as other visual and non-visual symptoms.
This condition significantly impairs quality-of-life. Despite its pervasive impact, there have been no effective treatment modalities, primarily due to the complex and poorly understood nature of the syndrome.
However, our groundbreaking pilot study, conducted by the clinics of Dr. Terry Tsang Optometry, Inc. and Neuro-Vision Associates of North Texas, offers new hope. This research explores the potential of Neuro-Optometric Rehabilitation Therapy (NORT) to reduce symptoms and enhance life quality for those afflicted.
Our work was published in the medical journal Frontiers in Neurology, and we presented our therapy to members of the Australasian College of Behavioural Optometrists.
After experiencing success with our patients, both with the reduction in visual symptoms of dots, after images, etc., and also their ability to resume function with daily living, we teamed up to design this study to help increase awareness of the possibility that neurovisual rehabilitation is a viable method to help this community.
At the time of the study design, there was no statistically trackable method for quantifying the visual symptoms that VSS patients experience. Since many experienced significant quality-of-life changes in addition to the reduction of visual snow symptoms, we chose a quality-of-life questionnaire as the assessment tool.
We used the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) as the measure to assess changes in various life aspects. These include general vision, social functioning, mental health, and dependency among others, over a structured 12-week therapy period. The objective is clear and compelling: to furnish empirical evidence on NORT’s efficacy, paving the way for its adoption as a standard care approach if proven successful.
Twenty-one participants diagnosed with VSS underwent a series of neuro-optometric sessions tailored to their specific needs, conducted by a qualified vision therapist or neuro-optometrist. The NEI-VFQ-25, a comprehensive tool for assessing vision-related quality-of-life, was administered at three key intervals: baseline, six weeks, and twelve weeks. This allowed for dynamic observation of any changes or trends that could be directly attributed to the therapy provided.
At the time of the study, NORT was not widely implemented in the clinical field for VSS, making this study among the first to delve into its potential benefits systematically. The therapy includes a variety of exercises designed to improve oculomotor function, visual processing speed, and accuracy, which are often compromised in VSS patients.
The study illuminates several key benefits of NORT:
1. Improved general vision: Patients showed significant improvements in general vision scores from baseline to 12 weeks.
2. Enhanced distance and near vision activities: Marked progress was noted in tasks involving distance and near vision, crucial for daily functioning.
3. Better social functioning and mental health: There were notable enhancements in social and mental domains, suggesting that NORT could help alleviate some of the psychological burdens associated with VSS.
4. Reduced dependency: As vision improved, patients reported a decreased reliance on others, fostering greater independence.
5. Statistically significant results: The improvements noted were statistically significant, lending weight to the therapy’s effectiveness.
6. Sustainable improvement: Gains in quality-of-life were not only achieved but sustained over the study period.
7. Tailored therapeutic approach: Each patient received customised treatment, enhancing the effectiveness of the intervention.
8. Innovative techniques: The use of advanced neuro-optometric tools and techniques provided a cutting-edge treatment framework.
9. Safe and non-invasive: Unlike pharmacological treatments, NORT is non-invasive, presenting a lower risk profile.
10. Pioneering research: This study contributes significantly to the existing literature by filling in gaps in the understanding and management of VSS.
With the potential to significantly improve patient outcomes through a relatively unexplored therapeutic path, NORT offers a new approach to managing VSS. The detailed data analysis provides a foundation for further research, potentially influencing treatment protocols across neuro-optometry.
The holistic improvement in patients’ lives observed in this study underscores the profound impact that such therapeutic methods can have.
About the authors
Names: Dr Terry Tsang; Dr Charles Shidlofsky
Qualifications: FCOVD, FAAO; OD FOVDR FNAP
Affiliations: Optometric Vision Development & Rehabilitation Association, Neuro-Optometric Rehabilitation (NORA); NORA president, International Sports Vision Association past president
