The efficacy of neuro-optometric visual rehabilitation therapy in patients with visual snow syndrome

Objective: This study intends to evaluate the feasibility of Neuro-Optometric Rehabilitation Therapy (NORT) to treat Visual Snow Syndrome (VSS). This pilot study utilized the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) to assess quality of life (QOL) before and after treatment.

Methods: Twenty-one participants were recruited as successive intake patients diagnosed with VSS at the clinics of Dr. Terry Tsang Optometry, Inc and Neuro-Vision Associates of North Texas. Participants completed the NEI Visual Function Questionnaire 25-2000 edition and performed NORT, conducted by a neuro-optometrist or a qualified vision therapist. The NEI-VFQ-25 was administered before, at 6 weeks, and at 12 weeks of NORT to evaluate the effects of treatment on patient QOL.

Results: The participants demonstrated an improvement in QOL composite and subscale scores after 6 and 12 weeks of NORT treatment. The NEI-VFQ-25 composite scores from the pre-test (M = 68, SD = 18) and at 6 weeks of treatment (M = 75, SD = 17) indicate an improvement in QOL [t (20) = 4.0, p = 0.0007]. The NEI-VFQ-25 composite scores from pretest to 12 weeks of treatment showed further improvements. This trend of improvement on NEI-VFQ-25 composite scores continued into the 12th week (M = 77, SD = 17) of treatment [t (20) = 4.5, p = 0.0002]. The subscales of general vision, distance activities, near activities, social functioning, mental health, role difficulties and dependency also showed improvement.

Conclusion: Our results suggest that patients with VSS experience improvement in QOL in as little as 6 weeks, with further improvement by 12 weeks of NORT. This suggests NORT is an effective treatment option for managing the condition and improving QOL in patients with VSS, although a reduction in specific symptoms has yet to be demonstrated. This study provides justification that NORT warrants further investigation on VSS symptom reduction.