While speech, physical and occupational therapies are the long-standing treatment standards for stroke and brain injury survivors, NovaVision Sight Science developed its VRT and NeET vision restoration therapies to help stroke and brain injury patients regain their vision, mobility, confidence and quality of life. Learn the answers to frequently asked questions about the basics of vision rehabilitation, including how long the therapy takes, how it works, and more.

General

How Do I Know If I Have A Visual Field Loss?

How Do I Know If I Have A Visual Field Loss?

NovaVision has developed a free vision test designed to help people determine if they have experienced neurological vision loss after a stroke or brain injury which can be performed online with instant preliminary results. While simpler than a visual field diagnostic test available from opticians or physicians, this vision test includes key elements of tests that might be used by an optician or physician. We hope the results of your test can help you discuss your vision concerns with your physician. To determine properly the presence of a visual defect, the results of this free vision test should be combined with a complete vision evaluation with an optician or physician.

What is Vision Restoration Therapy?

What is Vision Restoration Therapy?

VRT is a restoration therapy designed to improve visual sensitivity in the previously blind zones by using light to stimulate the border between the “seeing” and “blind” visual fields. NovaVision VRT is designed to restore vision loss due to stroke or brain damage and is supported by 20 clinical studies and decades of research. VRT is available in the EU, the US and selected locations internationally in both English and German language versions.

Visual field loss prevents patients from engaging in many normal day-to-day activities such as reading, dining out, walking without bumping into things, and driving. In a retrospective study, more than 70 percent of patients who completed VRT showed measurable improvements in their vision that enhanced their quality of life.1

1 Romano JG, et al, Visual field changes after a rehabilitation intervention: Vision Restoration therapy, J Neurol Sci (2008), doi:10.1016/j.jns.2008.06.026

What is Neuro-Eye Therapy?

What is Neuro-Eye Therapy?

NovaVision’s Sight Science NeET works on the basis that repeated stimulation of the blind or transition areas by specific spatial patterns can lead to increases in sensitivity of the blind areas, strengthening the residual vision and neuronal networks. Repetitive stimulation has proven effective in the recovery of other functions such as movements of lower limbs after stroke. The patient responds to the images that appear on the screen, initially in the border area of the patient’s visual field loss and over time deeper within the damaged field of vision. NeET is available in the EU.

What is the difference between the VRT and NeET vision restoration therapies?

What is the difference between the VRT and NeET vision restoration therapies?

Both VRT and NeET work on the basis that repeated stimulation of the blind or transition areas by specific spatial patterns can lead to increases in sensitivity of the blind areas. While VRT uses light to stimulate the light-flux visual processing channel, NeET uses objects and images to stimulate the spatial visual processing channel. VRT stimulates the border between the “seeing” and “blind” zones while NeET starts its stimulation close to the border zone and then moves into the blind zone.

VRT is delivered over the Internet to a patient’s computer, with a chinrest being supplied by NovaVision Sight Science; NeET is currently provided on a laptop supplied by NovaVision Sight Science together with a chinrest. Both therapies recommend 1-2 sessions of approximately 25 minutes, 5-6 days a week for approximately 6 months. NeET has more self-adaptive features therefore requiring less clinician time and progress reports are provided at the end of months 1, 3 and 6; for VRT reports are provided every month.

See The Science Behind Neuro-Eye Therapy for additional information.

Does VRT and NeET have any age limitations?

Does VRT and NeET have any age limitations?

Although there are no age limits for the therapies, VRT and NeET are not recommended for children, due to the requirement to be able to concentrate for two sessions of 15-25 minutes a day, five or six days a week.

Does the amount of time since an injury affect whether a patient qualifies for VRT and NeET?

Does the amount of time since an injury affect whether a patient qualifies for VRT and NeET?

The time between the injury and beginning therapy does not affect efficacy. There have been many successful outcomes for patients who suffered vision loss decades before receiving the therapy.

Can myopia or farsightedness be treated with VRT and NeET?

Can myopia or farsightedness be treated with VRT and NeET?

VRT and NeET are indicated only to treat visual impairments caused by neurological disorders such as strokes, head injuries, and brain tumours. Refractive errors like myopia, hyperopia, astigmatism, or presbyopia are not treated with VRT and NeET.

Who is eligible for VRT and NeET?

Who is eligible for VRT and NeET?

Most patients with visual field defects as a result of neurological trauma, who have some residual vision and no physical damage to the eye, are eligible for VRT and NeET and may benefit from the treatment. However, there are certain conditions in which the therapies may not be suitable or which may interfere with the effectiveness:

    • Patients with a history of seizure disorders, especially those who are photosensitive, must NOT undergo VRT or NeET until they have consulted with their health care professional. In patients with uncontrolled photosensitive seizure disorders, visual stimulation may have adverse effects including, but not limited to, seizures.
    • Those with significant cognitive deficits.
    • We recommend that patients suffering from acute inflammation of the eyes or central nervous system delay therapy until the acute phase is over.

Patients need to have the ability to sit upright and concentrate on a task without distraction for 15-30 minutes, should be motivated towards rehabilitation and able to commit to approximately an hour a day of therapy, five or six days a week. Because the treatment requires patients to be seated for extended periods, patients who have been previously diagnosed with deep vein thrombosis (DVT), or who may have an increased risk of experiencing DVT, should consult with their physician before initiating the VRT or NeET therapy program.

For full details of the patient requirements, contraindications, warnings, and precautions, please view the Patient Requirements section.

What vision defects can be treated with VRT and NeET?

What vision defects can be treated with VRT and NeET?

NovaVision’s VRT and NeET are intended for the diagnosis and improvement of visual functions in patients with impaired vision that may result from trauma, stroke, inflammation, surgical removal of brain tumour(s) or brain surgery.

VRT and NeET can treat any of the following vision defects:

  • Hemianopia (decreased or lost vision in one-half of the visual field)
  • Quadrantanopia (decreased or lost vision in one-quarter of the visual field)
  • Scotoma (island of visual impairment)
  • Diffuse field defect, including constriction of the field of vision (tunnel vision) caused by a tumour, brain surgery, or brain disorders

Benefits & Risks

What is the success rate of VRT?

What is the success rate of VRT?

A retrospective study of 161 patients from 16 medical centres across the US demonstrated that 76% of patients who completed this type of vision rehabilitation showed measurable improvements in their vision fields¹. Other studies have produced similar results. As with all therapies individual results vary, and there is no way to predict how you will respond to VRT.

¹ Romano JG, et al, Visual field changes after a rehabilitation intervention: Vision Restoration therapy, J Neurol Sci (2008), doi:10.1016/j.jns.2008.06.026 (NovaVision sponsored study)

What is the success rate of NeET?

What is the success rate of NeET?

Clinical studies published in peer reviewed scientific journals2 have shown that after a three-month training period on the program, clients experience improvements in their visual sensitivity within the damaged area of their visual field and the size of the affected area is often reduced. At the end of therapy, clients have reported on the practical advantages of NeET. These include better detection of moving or flickering objects such as traffic, improvements in reading and visual attention, improved navigational skills, and greater concentration and confidence—all of which can lead to improved quality of life. Approximately a third of our patients experience a great enough improvement to justify extending the length of their therapy.

It is important to note that the site and extent of brain damage as well as the response to therapy are different in each person and therefore improvement cannot be guaranteed.

2 See The Science Behind NeET for more detail on the clinical data.

Does VRT or NeET have any side effects?

Does VRT or NeET have any side effects?

In common with all activities requiring extended use of a computer screen, VRT and NeET may cause light headaches or fatigue if performed too intensively or without sufficient relaxation periods (breaks). If this occurs, patients should take more frequent breaks during the session or request shortened therapy times. If this persists, patients should temporarily discontinue the therapy until symptoms subside and notify NovaVision Sight Science or their healthcare professional.

What are some of the improvements patients have described after undergoing vision rehabilitation?

What are some of the improvements patients have described after undergoing vision rehabilitation?

Most of the improvements patients describe after undergoing vision rehabilitation involve reading, walking / mobility, confidence / independence, hobbies, watching TV, and dining out. Patients also report a decrease in injuries from falls and bumps.

For more information, and to hear about results from a patient perspective, please read, watch and listen to NovaVision’s patient stories.

How much vision can I expect to regain?

How much vision can I expect to regain?

This is difficult to estimate because each case is unique. However, clinical data has shown that the average vision gain from VRT vision rehabilitation is an approximate five degree shift in the border of the blind field, which can have an exponential impact on a patient’s daily life.¹ A 5 degree shift in the border of the blind field often leads to better reading, better mobility, less collisions, among other effects. For the majority of patients, the improvement is not sufficient to return to driving, however, some patients have achieved this goal.

Most NeET patients find that after 6 months of therapy they are able to detect the images used in training at locations within the area of sight loss (1-12° or more).

¹ Romano JG, et al, Visual field changes after a rehabilitation intervention: Vision Restoration therapy, J Neurol Sci (2008), doi:10.1016/j.jns.2008.06.026 (NovaVision sponsored study)

Process

How do I start my VRT or NeET therapy?

How do I start my VRT or NeET therapy?

The first step is to check whether you would meet the eligibility requirements for the therapy and then call NovaVision Patient Services or register online. You will require a visual field test, which can be obtained from most ophthalmologists or eye physicians, and during the registration process NovaVision Sight Science will verify your candidacy and if needed help you to locate an ophthalmologist or physician who can do this for you and provide information they may need.

For VRT: Once your registration is complete and you have made payment, NovaVision will send you a chinrest and activate your therapy license. Once you have received the chinrest you will be able to download and install the therapy on your computer. Guides will be provided to help you on how to download, set up and start your therapy. You will then complete a series of tests to evaluate your vision deficit. NovaVision analyses the test results to create and send you a customised therapy program.

For NeET: Once your registration is complete and you have made payment, NovaVision will send you a chinrest and a laptop with the therapy installed and customised for your deficit based on your visual field test. Guides will be provided to help you on how set up and start your therapy. After the first month NovaVision Sight Science evaluates your results and makes any required adjustments.

You may contact NovaVision Sight Science by email or call us on +44 1224 517385 to ask questions or request more information.

During my therapy when should I see my doctor?

During my therapy when should I see my doctor?

NovaVision Sight Science will continually monitor your deficit and your progress. If you wish, your physician can receive your progress reports and it is up to you and your doctor if you need to meet during or at the end of your therapy, although this is not required by NovaVision.

How is my therapy program determined?

How is my therapy program determined?

At the start of  VRT you will take several tests that will map your area of visual impairment. From these initial tests NovaVision will determine the location of  the visual deficit, and how and where to target the therapy. With NeET, when you receive your laptop the therapy is already customised based on your visual field test, and then adjusted at the end of the first month based on your actual results. Your therapy regimen will be updated regularly based on your progress and the status of your deficit.

Is VRT or NeET covered by insurance?

Is VRT or NeET covered by insurance?

VRT and NeET are registered with the UK Medicines and Healthcare products Regulatory Agency MHRA. However, VRT and NeET is not available on the NHS and is not generally covered by health insurance. With proper documentation, however, in certain circumstances a small number of NovaVision’s patients have had success gaining insurance coverage for the therapy. This may take persistence and result in delays to you commencing treatment. If you wish to submit a claim or an appeal, please contact NovaVision on +44 1224 517385 who can assist you.

How much does the therapy cost?

How much does the therapy cost?

NovaVision provides VRT in a therapy suite with NeuroEyeCoach at a total cost of £575. This provides six months therapy for VRT and the complete 36 sessions of NeuroEyeCoach. NovaVision provides NeET on its own at a total cost of £400 for six months of therapy. NovaVision will send you a chinrest for VRT for which we require a £75 deposit in the UK (£100 in rest of EU and £125 outside the EU). For NeET we will send you a chinrest and a laptop for which we require a £200 deposit in the UK (£250 in rest of EU and £300 outside the EU). Deposits are refunded when you return the equipment at the end of your therapy. All shipping costs within the UK are paid by NovaVision.

How long does VRT or NeET take to complete?

How long does VRT or NeET take to complete?

Generally it is recommended that you complete 6 months of twice-daily therapy, six days a week for VRT and five days a week for NeET, however, everyone responds differently to therapy. After the initial 6 months of therapy you should be re-evaluated by NovaVision Sight Science or your doctor to determine if it will be beneficial to continue therapy.

How do I perform the therapy?

How do I perform the therapy?

VRT and NeET are performed on your computer in the comfort of your home. It is recommended to set up the computer and chinrest on a desk or table with a comfortable chair in a quiet, dimly lit room, free of distractions. NovaVision Sight Science Patient Services is available to help you get started should you need assistance and can be reached by calling +44 1224 517385. You will also be provided with detailed setup instructions.

During a 25-30-minute VRT session, you will focus on a central point on the computer screen and respond whenever you see a light stimulus appear or when the fixation point changes in shape and colour. During a 25-30-minute NeET session you will respond to images that appear on the screen. At first the images will appear in the border between the damaged and undamaged parts of your vision; over time as you progress the images may appear deeper within your damaged field of vision.

Questions About VRT or NeET and NeuroEyeCoach

I don’t understand the difference between VRT or NeET and NeuroEyeCoach?

I don’t understand the difference between VRT or NeET and NeuroEyeCoach?

These therapies follow two different approaches to dealing with visual field deficits resulting from neurological brain damage:

Restoration: aims at improving visual sensitivity within the blind area by repeated stimulation, allowing patients to detect objects within the blind field. VRT and NeET are both restoration therapies, although they address restoration in slightly different ways.

Compensation: patients learn to direct their gaze towards the affected area bringing previously unseen objects into sight thereby allowing the patient to make the most of their remaining vision. NeuroEyeCoach is an example of this type of therapy.

If I want to do the VRT and NeuroEyeCoach therapy suite and am considering which therapy to perform first – what is the Company’s recommendation?

If I want to do the VRT and NeuroEyeCoach therapy suite and am considering which therapy to perform first – what is the Company’s recommendation?

The sequencing of the two therapies is entirely a matter of personal preference and the Company does not make a recommendation. NeuroEyeCoach is supported by several decades of scientific research, which shows that by training you to make effective eye movements you quickly become able to better cope with your daily tasks. NeuroEyeCoach can typically be completed in 2–4 weeks with benefits being experienced within this time frame. NovaVision VRT is a restoration therapy, where some lost vision is regained, and typically it will be approximately three months before you start to experience a tangible benefit from the therapy’s routine.

You are not able to perform both therapies at the same time so must have completed the initial therapy before moving onto the other therapy.

Does it matter how often I do the therapy, as I was planning on going on holiday in a couple of weeks?

Does it matter how often I do the therapy, as I was planning on going on holiday in a couple of weeks?

The frequency of your therapy sessions is important in order to maximise the benefits you will derive from it. It is therefore recommended that you perform the therapy twice a day, five (NeET) or six (VRT) days a week. You should also try not to have a long break during the therapy period; if you are planning a holiday or trip during which you will not have access to a computer that meets the technical requirements or not be able to perform the therapy on a regular basis, it is recommended that you commence the therapy on your return.

Questions About Technical Requirements

What technical requirements are there – what do I need to have to perform the therapy?

What technical requirements are there – what do I need to have to perform the therapy?

NeET is currently supplied by NovaVision Sight Science on a laptop, together with a chinrest. Reports and updates can be transmitted by email or by post using the supplied USB stick.

For VRT and NeuroEyeCoach, technical requirements are:

  • Internet connection
  • PC (desktop or laptop) with Windows XP Service Pack 3, Windows Vista, Windows 7 or Windows 8/8.1. VRT is not compatible with Apple OS, however can be used with an Apple computer if Windows or a program such as Parallels (www.parallels.com) is installed.
  • Screen size of 15” (diagonal) or greater is required. Minimum screen resolution is 1024(W) x 768(H) and VRT will not operate below this minimum resolution.
  • Some familiarity with computer operation and Internet browsing. VRT requires an initial download and run of an Installation program from the NovaVision website portal. Your progress reports are also downloaded from the same portal.

Please note that, prior to registration, the NovaVision portal will run a check on the technical attributes of the computer equipment being used to access the portal and will inform you if the technical requirements are not met.

All technical requirements are also stated on the website for your review.

Can I perform VRT on two different computers, for example, my desktop and my laptop?

Can I perform VRT on two different computers, for example, my desktop and my laptop?

As long as both computers meet the technical requirements you can perform VRT on both; your position in the therapy program will be synchronised each time you log on and will always start at the correct position on whichever device is used. However, each time you change from one computer to the other you will need to re-calibrate to ensure you are the correct viewing distance from the screen; this is an easy process that is explained in the QuickStart Guide.

How can I see what type of operating software I am currently running?

Click on your Start Menu and right click on Computer/My Computer and select Properties.

The window displayed below will open and your Operating System information will be visible under Windows Edition.

What software am I running

How can I determine my screen resolution?

How can I determine my screen resolution?

Right click on your desktop and select Display Options/Screen Resolution which will reveal the window below.

Screen resolution settings for NeuroEyeCoach

I like to set my screen resolution lower so that the fonts on my screen appear larger, can I do that with the NovaVision therapies?

I like to set my screen resolution lower so that the fonts on my screen appear larger, can I do that with the NovaVision therapies?

As long as the screen resolution is not set to lower than the minimum resolution stated above, the NovaVision therapies will be able to operate. If you prefer to set your resolution lower than the minimum requirement, you will need to adjust it before each therapy session using the same Screen Resolution window pictured above. If you forget, a warning will appear requesting you to adjust your resolution.

Why are you not supporting service Windows XP service pack 2 (or earlier)?

Why are you not supporting service Windows XP service pack 2 (or earlier)?

Windows XP Service Pack 2 is currently not supported by Microsoft and is not compatible with the technical framework and pre-requisites required for the NovaVision therapies.

I am currently running Windows XP Service Pack 3. I understand Microsoft has stopped supporting this. What will that mean in terms of being able to perform the therapy?

I am currently running Windows XP Service Pack 3. I understand Microsoft has stopped supporting this. What will that mean in terms of being able to perform the therapy?

The current version of VRT currently supports Windows XP Service Pack 3 and will continue to do so regardless of Microsoft’s support of the operating system. This may be subject to change for subsequent releases of the NovaVision therapies.

I have an Apple computer, can I run the NovaVision therapies?

I have an Apple computer, can I run the NovaVision therapies?

The NovaVision therapies will not run on an Apple operating system. However, Windows can be installed on all modern Apple computers and there are also programs such as Parallels (www.parallels.com) which enable Windows-based programs to be run on Apple computers. The NovaVision therapies cannot be used with an iPad although you will be able to access the Portal and review your progress and reports on an iPad if you wish.