The PC-based treatment approach was originally developed by Prof. Zihl (1988, 1990) and has since been used with various modifications in 13 studies on a total of 551 patients with homonymous visual field loss and persistent visual disabilities.
The main outcome of saccadic training is a significant improvement in visual search performance accompanied by more efficient oculomotor strategies, and a reduction in visual disability as assessed by standardized questionnaires and behavioral measures. These include measures of improvements in navigation skills and object finding. The efficacy of this treatment approach to improving of visual overview and visual exploration is superior to practice with reading (Schuett et al., 2012), non-specific visual training (Roth et al., 2009), standard occupational therapy (Mödden et al., 2012) or counseling with regards to coping strategies (Zihl, 2011). Importantly, time since brain injury (Zihl, 2011) and age of hemianopic patients (Schuett & Zihl, 2012) do not play a significant role in the treatment effect.
Use of visual search in improving search efficiency of hemianopic patients was first reported in 1988. Other than its use in various forms in a limited number of rehabilitation clinics over the past 25 years, there has been a marked lack of an evidence based vision specific medical device broadly accessible to patients despite there being a large body of evidence, including randomized control trials that have shown that patients benefit from systematic eye movement training.
NeuroEyeCoach was developed to address this need and was based upon this body of evidence to provide a standardised protocol for clinical management of patients using a compensatory technique. In October 2016, the therapy was validated by a three-center peer reviewed study, published in “BioMed Research International”. The study was conducted by the School of Psychology of University of Aberdeen, the Neuromotor and Cognitive Rehabilitation Research Centre of University of Verona, and the Department of Psychology of University of Munich. The Paper states that NeuroEyeCoach is an effective compensatory approach for those with homonymous visual field loss. The training led to faster visual search times, reduction in the number of errors made, and improvements in reported activities of daily living.
The study concludes “NeuroEyeCoach can be used as an effective rehabilitation tool to develop compensatory strategies in patients with visual field deficits after brain injury” and that NeuroEyeCoach can be viewed as being the first evidence-based, vision-specific, clinical gold standard registered medical device accessible to patients at home or in clinical settings. See our blog for more information on this study.
NeuroEyeCoach Clinical Studies
- Use of NeuroEyeCoach to improve eye movement efficacy in patients with homonymous visual field loss
Author: Sahraie, A., Smania, N., Zihl, J.
Publication: BioMed Research International http://cdn2.hubspot.net/hubfs/548508/PDFs/Use_of_NeuroEyeCoach_to_Improve_Eye_Movement_Efficacy_in_Patient_with_Homonymous_Visual_Field_Loss.pdf
- Visual scanning behaviour in patients with homonymous hemianopia
Author: Zihl, J.
Publication: Neuropsychologia, 1995, 33:287-303.
- Rehabilitation of Visual Disorders after brain injury
Author: Zihl, J.
Publication: Psychology Press, 2nd Edition, Hove (GB) and New York (USA), 2011.
- Guided Search 2.0, A revised model of visual search
Author: Wolfe, J.
Publication: Psychonomic Bulletin & Review Vol 1 (2), 1994, 202-238.
- Rehabilitation of homonymous scotomata in patients with postgeniculate damage of the visual system: Saccadic compensation training
Authors: Kerkhoff, G., Münssinger, U., Haaf, E., Eberle-Strauss, G., Stögerer, E.
Publication: Restorative Neurology and Neuroscience, 1992, 4:245-254.
- Compensatory strategies following visual search training in patients with homonymous hemianopia: an eye movement study
Authors: Mannan, S.K., Pambakian, A.L.M., Kennard, C.
Publication: Journal of Neurology, 2010, 257:1812-1821.
- Eye-movement training-induced plasticity in patients with post-stroke hemianopia
Authors: Nelles, G., Pscherer, A., de Greiff, A., Forsting, M., Gerhard, H., Esser, J., Diener, H.C.
Publication: Journal of Neurology, 2009,256:726-733.
- A randomized controlled trial comparing 2 interventions for visual field loss with standard occupational therapy during inpatient stroke rehabilitation
Authors: Mödden, C., Behrens, M., Damke, I., Eilers, N., Kastrup, A., Hildebrandt, H.
Publication: Neurorehabilitation and Neural Repair, 2012, 26:463-469.
- Rehabilitation of reading and visual exploration in visual field disorders: transfer or specificity?
Authors: Schuett, S., Heywood, CA., Kentridge, R.W., Dauner, R., Zihl, J.
Publication: Brain, 2012, 135:912-921.
- Compensatory visual field training for patients with hemianopia after stroke
Authors: Nelles, G., Esser, J., Eckstein, A., Tiede, A., Gerhard, H., Diener, H.C.
Publication: Neuroscience Letters, 2001, 306:189-192.
- Saccadic visual search training: A treatment for patients with homonymous hemianopia
Authors: Pambakian, A.L.M., Mannan, S.K., Hogson, T.L., Kennard, C.
Publication: Journal of Neurology, Neurosurgery, and Psychiatry, 2004, 75:1443-1448.
- Incidence of neurological vision impairments in patients who suffer from an acquired brain injury
Author: Clarke, G.
Publication: International Congress Series, 2005, 1282:365-369.
- Changes in stroke epidemiology, prevention, and treatment
Author: Kinley, S.
Publication: Circulation, 2011, 124:e494-e496.
- Heart Disease and Stroke Statistics—2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Authors: Lloyd-Jones, et al.
Publication: Circulation, 2009, 119:e21-e181.
- Visual impairment after stroke: Do patients require vision assessment?
Authors: Rowe, F., Brand, D., Jackson, C.A., Price, A., Walker, L., Harrison, S. et al.
Publication: Age and Ageing, 2009, 38:188-193.
- Does age matter? Age and rehabilitation of visual field disorders after brain injury
Authors: Schuett, S., Zihl, J.
Publication: Cortex, 2013, 49(4):1001-12.
- The frequency of occurrence, types, and characteristics of visual field defects in acquired brain injury: A retrospective analysis.
Authors: Suchoff, IB., Kapoor, N., Ciuffreda, K.J., Rutner, D., Han, E., Craig, S.
Publication: Optometry, 2008, 79:259-265.
- Stroke incidence and prevalence in Europe: a review of available data
Authors: Truelsen T., Piechowski-Jóźwiak B., Bonita, R., Mathers C., Bogousslavsky J., Boysen, G.
Publication: European Journal of Neurology, 2006, 13:581-598.
- Homonymous hemianopia in stroke
Authors: Zhang, X., Kedar, S., Lynn, M.J., Newman, N.J., Biousse, V.
Publication: Journal of Neuro-Ophthalmology, 2006, 26:180-183.
- Sehen (engl.: Vision)
Author: Zihl, J.
Publication in: Neuropsychologische Rehabilitation. Grundlagen – Diagnostik – Behandlungsverfahren. Von Cramon D. & Zihl, J. (Eds)., 1988, pp. 105-131. Berlin: Springer.
- Treatment of patients with homonymous visual field disorders [in German]
Author: Zihl, J.
Publication: Zeitschrift für Neuropsychologie, 1990, 2:95-101 (no link available)