baseball,

I can speak for myself regarding vision therapy. ** No, I have not had any vision therapy. Not because I do not believe in it. I believe it has valid applications. I do not suffer from any vision problems that are treatable with vision therapy. My visual memory problem is singular. By that I mean it is not caused by or made worse by any of the other treatable vision dysfunctions.

My photo-sensitivity has existed for over 40 years. Since I need corrective lenses, I use photo-chromatic lenses to lessen the brightness around me. This is the standard treatment.

Even though I have a reasonably strong astigmatic problem (3.5 diopters), otherwise, I have excellent range of view and ability to discern objects in a cluttered field. These abilities have remained stable or improved over 45 years. I have slight convergence difficulties that are attributed to my astigmatism. My brain is so precise in its interpretation of visual information that I need a very accurate astigmatic correction. My astigmatic correction axis must be well within 2 degrees. This creates a serious problem between the optometrist and the dispensing optician.

My visual difficulties are due to my brain not being able to filter out excessive and extraneous visual stimuli. I have the same problem with auditory processing, only worse. This problem has only existed since my 2001 injury. Prior concussions did not cause any lasting deficiencies in this area.

There is a big difference between an optometrist and an ophthalmologist. There are optometrists who are trained in vision therapy but they are the exception rather than the rule. They can be life savers if the vision problem is treatable.

My suggestion was finding a neuro-ophthalmologist. They have additional training beyond the generic ophthalmologist. Although I have an understanding of therapeutic optometrists, I neglected/forgot to mention this therapy.

I doubt you will find an ophthalmologist who will offer a free consultation. Some of the more holistic optometrists may offer a free introductory consult but beware the practitioner who offers a free consult that is really a "show and sell." They will use the time to sell their therapy/practice rather that look into your specific needs. I am very hesitant of professionals who feel the need to give a sales presentation. There are too many snake oil salespeople out there.

I have had too many free consults that were just an effort to bring in a new patient, regardless of diagnosis.

There are a variety of vision therapies. The most common is used to correct or improve vision problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities. Double vision and convergence insufficiency are common symptoms of PCS. There are some reading difficulties that are also common to PCS.

EMDR is a common alternative vision therapy. Eye Movement Desensitization and Reprocessing (sometimes called Reprogramming) is intended to resolve past stressful experiences. It is rather controversial but has many strong proponents. Since it does not require a specific piece of equipment, EMDR does not fall under the FDA Regulatory system.

ROSHI and pROSHI are not within the normal range of vision therapy. They are passive therapies (the patient does nothing) that use the visual system to try to use light pulses to stimulate the brain into a different and hopefully corrected wave form. ROSHI and pROSHI are FDA labeled as relaxation therapy devices.

Their promotion for other symptoms is definitely off-label. As I stated earlier, they are based on a philosophical/religious principle that some may find objectionable. Here is a listing of the publications and presentations **. http://www.nnrionline.com/index_files/Page1276.htm

**

There is a big difference between a psychologist and a psychiatrist. The former is a Psy.D. or Ph.D. The Psy.D. is trained in the psychological diagnostics and therapies. The Ph.D. requires understanding the research and statistical methods of the Psychological discipline. A neuro-psych has additional training and residency requirements in the neuro testing and assessment fields.

A psychiatrist is an M.D. sometimes with a Ph.D. also. Some psychiatrists add a neurology study/residency to their training. The depth of medical/physiological knowledge of a psychiatrist can be very helpful with PCS. Psychiatrists often have more psychological knowledge that psychologists have psychiatric knowledge.

The psychological versus physiological needs of a brain injury are best treated in the proper order. The psychological needs can complicate the brain's attempt at physiological healing or improvement. Psychological stresses create a cascade of chemical processes (stress hormones) that can preclude physiological improvement.

The psychological aspects can be treated more specifically. The physiological aspects are not only difficult to diagnose specifically, but also difficult to treat specifically. Other than seizures and brain swelling and in the best cases head aches, the microscopic brain cell injuries are slow to respond to treatment.

One of the primary psychological components that are worth treating is the anxiety/OCD/depression . This is often a result of the "Am I going crazy?" or "Why is this happening to me?" repetitive thought process. PCS creates a physiological environment that makes anxiety a common problem. This is why many doctors use anti-anxiety/anti-depressant medication for PCS patients. The reduction in anxiety/depressive symptoms is read as a improvement of the PCS symptoms. At least, it causes the patient to not pester the doctor with such an intense hypochondriac style.

CBT (cognitive behavioral therapy) is also helpful with these anxiety/OCD/depression components. This starts with understanding the underlying physiological symptoms. This "redirecting thought" is very helpful as we try to deal with our symptoms. For me, it often means walking away when my mind wants to get angry. Adult 'time outs' can be very beneficial.

baseball, You are engaging in a good process. Understanding the different diagnostics and therapies is necessary prior to spending good money on them. It is also worthwhile to understand your own specific symptoms. Knowledge is power, especially when it is your own health, success and money at stake.

Keep asking questions and researching. Try to make it a point to differentiate between statistically validated evidence versus anecdotal (individual case reports) evidence. The placebo effect can often cause up to a 60% positive response. Statistically valid studies will address and/or adjust for the placebo effects.