Neuropsychologic rehabilitation for visuoperceptual impairments

Impairments of visual perception resulting from brain damage can have serious implications for many aspects of patients' lives, and these impairments should be targeted for intervention. Rehabilitation programs need to be individually tailored to each patient's needs; thus, characterization of a patient's visual perception and related abilities, by means of neuroophthalmologic and neuropsychologic evaluations, is a necessary starting point for rehabilitation. Several promising treatment approaches based on restorative and compensatory methods are described, although as yet there is limited systematic study of the efficacy of these methods. Treatment models and compensatory devices from the mature field of low-vision rehabilitation have obvious application in the rehabilitation of cortically based visual perceptual impairments. In addition, ongoing rapid advances in the cognitive neuroscience of vision are likely to provide guidance in the development of new interventions. One area in which functional imaging studies may prove useful is gaining information regarding critical periods of recovery and plasticity. For some visuoperceptual disorders, restorative procedures may be of particular benefit in facilitating brain reorganization during certain recovery periods, but rehabilitation specialists still have few empiric data to guide their efforts. Despite the major limitations in our understanding of key issues influencing outcome, most patients with cerebral visual dysfunction can receive some benefit from carefully designed rehabilitation programs.