Vision Therapy for Traumatic Brain Injury

TBII first came across Lt. Colonel Debra McNamara in a feature article about her in Review of Optometry’s Women in Optometry issue, September 2011.  The feature caught my eye for two reasons, one because our older son Elliot went to West Point and served two tours of duty in Iraq, and secondly because of these comments on p. 13:  “Dr. Debra McNamara is keenly interested in traumatic brain injury (TB) and posttrauma vision syndrome (PTVS).  Her optometry school professors ‘hammered home the importance of binocular function and how it pertains to sensory integration and vestibular function.  Having a strong binocular vision backgound has turned out to be an important clinical asest to have as a military optometrist’, she says.  ‘There are so many soldiers who have suffered TBI but have still not been diagnosed or treated for their PTVS.  There is real need for ODs who are interested in vision therapy and who enjoy the sense of camaraderies that develops when you collaborate with a team of occupational therapists, physical therapists, neurologists, psychologists, physicians, audiologists, nurse case managers and other health care providers to improve the life of soldiers.”

A special treat therefore to see this YouTube video from The Pentagon Channel’s Health Matters:

13 thoughts on “Vision Therapy for Traumatic Brain Injury

  1. Thanks Len for all the important things that you share with so many of us. When I started seeing TBI patients in the practice plan I told Norman that I wanted out and wanted to see the patients as part of my clinical assignments with residents. He said absolutely no, but I did it anyway, and the unit is now one of the most successful at the college thanks primarily to Neera, Ken and Alan. How was Spring training? My love to Miriam. Irwin

    • You’re welcome, Irwin. You certainly were a visionary in the field! Yes, SUNY continues to be at the vanguard. Spring Training has been delightful, thanks.

  2. Hi—I met Debra at some meetings related to the DoD and Vision Center for Excellence last year, where many of us, such as Mitch Scheiman and Felix Barker, and in conjunction with general medicine and ophthalmology, and others, developed suggested diagnostic and therapeutic protocols for vision problems in TBI that will likely be used (with possible modifications), in the near future. Her positive attitude, presence, confidence, and knowledgeable of optometry/binocular vision from a very practical sense, floored me.
    She should be cloned!!

  3. Great blog per usual Dr. P! I have had my “Veteran’s Vision program” in place for over 2 years now. If a vet comes to me with service related TBI,from service in Iraq or Afghanistan they get treatment for free. No paperwork, no hassle. Just help. We would see up to 4 vets at a time, but the visual problems with TBI are just not that widely known. I am a little over an hour from Fort Knox and have been able to help a few vets. Their results have been wonderful.

    • You’ll have to post that question to the ophthalmologists who don’t support it, Elena. I’ve made the point many times over in these blogs, and the American Optometric Association in its literature and journal have had a series of rebuttals against the ophthalmology position which is unsupportive, that Ophthalmology supports many of its own procedures with far less “evidence based medicine” than it claims is lacking for vision therapy.

  4. The answer to Elena’s insightful question, I believe, is really simple: in addition to the politics between the two groups to which Lenny alludes, and is correct, the ophthalmologists do not understand vision/visual processing, but rather understand only one inch of the visual system, namely the eyeball at the anatomical and physiological levels, which reflects their very narrow and biased education.

  5. Agreed, Ken. Though you won’t get many ophthalmologists to admit that. Most feel, as espoused by Granet in his comments on an earlier blog (see: that they are trained in and fully grasp the whole visual enchilada. I would therefore add to your assessment a certain arrogance that optometric perspectives and research are irrelevant. The only literature they will acknowledge vis-a-vis VT is their own, and the only studies that have veracity are ones in which they participate. That makes a mockery of “Evidence-Based Medicine”, rendering it to be what it is: “Medicine-Based Evidence”. I remain hopeful that there will be collaboratives that overcome these obstacles, one day making Elena’s question moot.

  6. I am blessed to have worked with LTC McNamara, and she is now a close, personal friend. Deb takes the Army core values of Integrity, Selfless Service, and Personal Courage to an extent most of us would never achieve in our wildest dreams. Her time in Afghanistan, the work she did there, and the things she was able to accomplish, is mind-boggling.I am a better person because I know her, and the entire Service (actually, the whole WORLD) is a better place because she is in it, doing everything she can, everyday, to make sure these conditions get diagnosed and treated. I can’t tell you how much I admire and respect this woman. She is one of the best. Period.

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