NACBO 2019: Brain snap

The Australasian College of Behavioural Optometrists (ACBO) hosted its annual national scientific meeting (NACBO) in mid-July, just before the inaugural O=Mega19 optical fair and conference in Melbourne. The conference attracted more than 120 delegates, including 14 from New Zealand, all keen to further their knowledge in neuro-optometric assessment and rehabilitation care for individuals who are experiencing visual sequelae having sustained concussion or acquired brain injury (ABI)

Exploring the visual consequences of concussion

As one of the most respected optometrists working in and researching the visual effects of concussion and head injury, NACBO keynote speaker Dr Neera Kapoor proved to be an excellent presenter of the science and practice of optometric care for patients in this area. Her well-structured series of lectures stemmed from her work at the State University of New York (SUNY) for many years, where she worked with several pioneers of neuro-rehabilitative optometry, including Drs Irwin Suchoff, Allen Cohen, Ken Ciuffreda and Barry Tannen. She currently practises in a multidisciplinary physical medicine and rehabilitation office in New York.

In Dr Kapoor’s first lecture we learnt about the pathophysiology and public health significance of concussion and mild ABI, why vision function may be impacted, the evidence-based occurrence of common sensorimotor vision conditions and high yield vision assessment techniques for neuro-optometric evaluation.

Her next lecture focused on stroke and vision, and shared specific information about visual field integrity, visual processing, various agnosia’s, cranial nerve palsies together with internuclear ophthalmoplegia. Further lectures covered primary eye care for those with ABI and neuro-optometric management approaches, case studies and management of visual-vestibular conditions. The key focus from the latter, was to understand how to determine if sensorimotor function is a contributing factor towards a patient’s vestibular symptoms and treatment methods for visual-vestibular dysfunction.

Concussion concerns

Other notable speakers included Michael Morton, an optometrist with the Brien Holden Vision Institute, who delivered an app interactive address on the clinical management of myopia, and NACBO executive director Steve Leslie from Perth, who discussed accommodation dysfunction in concussion and photophobia with ABI. I also was asked to take part and deliver some practical clinical pearls from my experience working with visual sequelae in patients who have sustained ABI, while Vivid Vision discussed virtual reality for treating binocular vision disorders.

Concussion can significantly affect visual function and while 86% of individuals improve within the first month from injury, many of those with persistent symptoms associated with diagnostic dysfunction in accommodation, convergence, binocular vision, pursuit and saccadic eye movements, photophobia, visual motion sensitivity and visual-vestibular function.

Hastings-based optometrist Niall McCormack produced an excellent article on acquired brain injury and optometry in NZ Optics’ March 2019 magazine (www.eyeonoptics.co.nz/articles/archive/an-optometrists-role-in-concussion/) for those wishing to learn more about this important subject.

2019 awards and looking ahead

Niall was also recognised at the 2019 NACBO awards ceremony during the Gala Dinner, receiving the Keith Woodland award for his altruistic service and significant contributions to behavioural vision care. Other awards were presented to Susan Walton, who received the ACBO president’s award for her contributions to behavioural optometry and services to the Australian Special Olympics Opening Eyes Program, and Claire Campitelli, who received the Graham Peachey award for services toward behavioural optometric education as chair of the fellowship committee. Steve Leslie, the retiring ACBO president was awarded emeritus fellowship, recognising exceptional service and dedication to behavioural vision care practice over his career.

If this has inspired you to think about improving your knowledge in neuro-optometric rehabilitation assessment and management for ABI, the conference was recorded and is available online at www.digivisionmedia.com, or consider attending next year’s NACBO or the international Neuro-Optometric Vision Rehabilitation annual conference.

ACBO wish to acknowledge the support it receives from their fabulous sponsors who made this conference possible: CR Surfacing, Vivid Vision, HILCO Vision, Good Optical Services and BOC Instruments.

Evan Brown is an Auckland-based behavioural optometrist with special interest in children's vision, traumatic brain injury, binocular vision dysfunction and visual skills for sport. He is the first New Zealand president of ACBO.

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