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FAQs: Vision Restoration Therapy — Vision Rehab after Stroke or TBI

Read below to learn the basics of Vision Restoration Therapy, including how this vision rehab program works, how long it takes to complete, the process of starting a patient on the therapy, and more.


What is Vision Restoration Therapy?

NovaVision® Vision Restoration Therapy (VRT) is based on groundbreaking research in visual neuroplasticity. VRT is an FDA-cleared, patented, non-invasive medical device that may restore vision in stroke and traumatic brain injury (TBI) patients with visual deficits. While speech, physical and occupational therapies are the long-standing treatment standards for stroke and TBI survivors, VRT is the first FDA-cleared clinical application of rehabilitation for vision loss.

Visual field loss prevents patients from engaging in many normal day-to-day activities. In a recent retrospective study, more than 70 percent of patients who completed VRT showed measurable improvements in their vision that enhanced their quality of life1.

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How do I start VRT?

The first step is to call NovaVision Patient Services to verify your candidacy and to locate a prescribing doctor in your area. Once a neuro-ophthalmologist, ophthalmologist, optometrist, neurologist or physiatrist has determined that you are a candidate for VRT and written a prescription, you will pay for three months of therapy so that a VRT device can be sent to your home. You will then complete a series of tests to evaluate your vision deficit. NovaVision then analyzes the test results to create and send you a customized therapy program. You may contact NovaVision by email or call us at 1.866.414.0009 to ask questions or request more information.

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Is Vision Restoration Therapy covered by insurance?

With persistence, patients have had success gaining insurance coverage for therapy from several carriers. Call NovaVision for assistance in submitting a claim for consideration.

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How long does Vision Restoration Therapy take to complete?

Generally it is recommended that patients complete 6 months of twice-daily VRT, however, everyone responds differently to therapy. After the initial 6 months of therapy the patient should be re-evalutated by their doctor to determine if it will be beneficial to continue therapy.

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Does Vision Restoration Therapy have any side effects?

The majority of patients who undergo Vision Restoration Therapy do not experience any noticeable side effects, though a small number of patients have reported infrequent headaches. If you experience discomfort or strain, you should consult your doctor.

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What vision defects can be treated with Vision Restoration Therapy?

NovaVision Vision Restoration Therapy is cleared by the FDA to treat visual impairments caused by stroke, head injury, brain tumors, and brain surgery.

Vision Restoration Therapy can treat any of the following vision defects:

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Can myopia or farsightedness be treated with Vision Restoration Therapy?

VRT is indicated only to treat visual impairments caused by neurological disorders such as stroke, head injuries, and brain tumors at this time. Refractive errors like myopia, hyperopia, astigmatism, or presbyopia are not treated with VRT.

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Who is eligible for Vision Restoration Therapy?

Most patients with visual field defects such as hemianopia, scotoma and quadrantanopia are eligible for Vision Restoration Therapy and may benefit from the treatment. However, there are certain conditions in which VRT may not be suitable. Those with photosensitive seizure disorder, serious eye disease and significant cognitive deficits may find that their condition interferes with VRT. In addition, we recommend that patients suffering from acute central nervous system or eye disease delay therapy until the acute phase is over.

VRT requires significant concentration and attention. Those with significant cognitive difficulties that would preclude understanding the instructions or maintaining attention for 30 minutes usually are not appropriate candidates for this version of VRT.

If your visual acuity is worse than 20/200, you may not be able to detect the stimuli reliably and therefore you should not complete VRT, but you may also wish to consult a VRT Advanced Care Center. Our screening tool is a good indicator of whether you can perform VRT successfully.

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How do I perform the therapy?

Vision Restoration Therapy is performed with a VRT device in the comfort of your home. During a 30-minute session, you will focus on a central point on the device screen and respond whenever you see a light stimulus appear. It is recommended to set up the device on a desk or table with a comfortable chair in a quiet, dimly lit room, free of distractions. NovaVision Patient Services is available to help you get started should you need assistance and can be reached by calling 1.866.414.0009. You will also be provided with helpful videos and instructions.

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How long does vision rehabilitation take to complete?

Vision restoration therapy is typically performed twice daily totaling an hour for six months, although patients who are continuing to benefit may continue on a monthly basis.

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How is my therapy program determined?

Once it is determined that you are a candidate for Vision Restoration Therapy you will take several tests on the VRT device that will map your area of visual impairment. From these initial tests NovaVision will determine the location of the borders of the visual deficit, and how to target them with therapy. Your therapy regimen will be updated regularly based on your progress and the status of your deficit.

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What occurs after five months of VRT?

NovaVision will continually monitor your deficit and your progress. After 5 months of treatment, it is recommended to meet with your doctor to determine if you should continue with therapy beyond the typical 6-month course. To learn more, please read the details of how VRT works.

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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. Fortunately, nearly 90% of patients have mentioned at least one meaningful benefit as a result of VRT2. For more information, and to hear about results from a patient perspective, please read NovaVision VRT success stories. To download our patient testimonial booklet click here.

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What is the success rate of VRT?

Nearly 90% of VRT patients surveyed have mentioned at least one significant benefit as a result of performing VRT, such as improved reading, mobility, and in a few cases, driving again2 . A recent retrospective study of 161 patients from 16 medical centers across the US demonstrated that over 70 percent 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.

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How much vision can I expect to regain?

Clinical data have shown that the average vision gain from VRT vision rehabilitation is a five degree shift in the border of the blind field, which can have an exponential impact on a patient's daily life. A 5 degree shift in the border of the blind field often leads to better reading, better mobility, less collisions, among other effects1. For the majority of patients, the improvement is not sufficient to return to driving, however, quite a few patients have achieved this goal. Nearly 88% of patients mention a significant improvement in quality of life2. Learn more about the studies that support these conclusions.

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Does vision rehabilitation have any age limitations?

There are no age restrictions for patients interested in vision rehabilitation after suffering a stroke or brain injury. The only requirement is that the patient must be able to concentrate for the hour a day it takes to perform the therapy.

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

The time between the injury and beginning therapy is not significant. There have been many successful outcomes for patients who suffered vision loss decades before receiving the therapy. One such case was that of a World War II veteran who benefited from VRT.

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How does VRT improve vision through the brain?

There is brain reorganization that results in visual field improvement. The precise mechanisms of brain reorganization are being studied. Some researchers hypothesis that neuroplasticity, activation of other visual pathways that were previously unused, and the use of localized attention. Learn more about the studies that support these conclusions.

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How much does the therapy cost?

The cost of treatment depends on how long the patient needs to perform therapy. Contact NovaVision for more details.

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What studies have been conducted on NovaVision Vision Restoration Therapy?

VRT was developed by Professor Bernhard Sabel, an active scientist in brain and vision repair. Prof. Sabel received his post-doctorate from the Massachusetts Institute of Technology, received his doctorate from Clark University as a Fulbright scholar under Donald Stein, Ph.D., pioneer in the field of neuroplasticity, has been an attending fellow at Harvard University (Massachusetts General Hospital) and Princeton University. In 2000, Prof. Sabel's work with VRT was awarded the European Cinquigrani Award for best innovation in communication and innovation technologies. His work has been published in Neurology, Restorative Neurology and Neuroscience, Journal of Cognitive Neuroscience, and Molecular Brain Research.

Additionally, VRT has been validated by 15 years of research conducted by several universities. These findings have been presented at many key professional conferences. To see a complete listing of the research with the principal investigator and institution where the study was conducted visit our research page.

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Is Eye Movement responsible for patient outcomes?

Given the complexity of the brain and that the study of neuroplasticity is in its infancy, some questions were originally raised that vision rehabilitation was occurring through eye movements instead of through self-repair in the brain. Following are several arguments that refute that eye movement is the primary mechanism responsible for recovery of function:

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How can I obtain information about prescribing VRT vision rehabilitation?

To obtain detailed information about prescribing VRT, please download our physician brochure and review the Diagnosis page. There you will find detailed information about the VRT process.

If you would like to become a part of NovaVision's Physician Directory and see potential candidates, visit the Physician Directory page.

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I prescribed VRT for one of my patients. How will I learn of my patient's progress with VRT?

When your patient sends in the prescription for VRT, your contact information will be recorded to provide you with patient progress reports. NovaVision is here to assist with interpretation of results or any questions you may have over the course of therapy.

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How do VRT results compare to results from a Humphrey or other visual field test?

NovaVision Vision Restoration Therapy (VRT) software uses high resolution perimetry to evaluate the patient's baseline visual field defect and to monitor therapy results over time. With the traditional Humphrey Visual Field (HVF) a larger test point spread of 6° is used between test points. Since the average shift in the border of vision impairment from VRT is approximately 5°, the traditional HVF may miss this change. During a patient's reassessment, the HVF disregards the previous results and creates a new baseline. Since the previous baseline is disregarded, the patient's threshold detection ability is not factored into their evaluation, and improvement in sensitivity is ignored.

Additionally, the Humphrey machine saves time by using very large increments of brightness when sub-normal vision is detected. As a result, visual improvements in threshold detection disability may be missed because the increments of sensitivity used in the test were too far apart.

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I have a patient who may need more assistance getting started. What should I do?

NovaVision has established advanced care centers for Vision Restoration Therapy that are able to offer greater assistance to those patients that may not be able to perform the VRT diagnostic portion to begin therapy in their home. These advanced care centers are well versed in VRT and in administering therapy to a patient who requires additional assistance. You can find a list of these centers by visiting our Advanced Care Centers page.

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How can I get more information?

To get more information on types of vision loss and how Vision Restoration Therapy can help stroke and head injury patients, please explore the following sections of our website:

Physician Directory you may also contact NovaVision by email or call NovaVision Patient Services at 1.866.414.0009.

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  1. Ramano 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
  2. Mueller I, Poggel DA, Kenkel S, Kasten E and Sabel BA. Vison Restoration Therapy after brain damage: subjective improvements of activities of daily life and their relationship to visual field enlargements. Visual Impairment Research 2003; 5: 157-178
  3. (Romano JG. et al. International Stroke Conference 2007; San Francisco, CA.)
  4. (E Kasten et al. Behavioural Brain Research 175 (2006) 18-26)
  5. Marshall RS, Ferrera JJ, Barnes A, Zang X, O'Brien KA, Chmayssani M, Hirsch J and Lazar, RM. Brain Activity Associated With Stimulation Therapy Of The Visual Border Zone In Hemianopic Stroke Patients. Neuro Rehabilitation Neural Repair. 2008 22(2):136-44.Epub 2007 Aug 14.