PTOTCase ReportAmerican journal of physical medicine & rehabilitation2017

Restoration of Vision After Brain Injury Using Magnet Glasses.

Kevin E Houston, Eleftherios I Paschalis, Danielle C Angueira and 3 others

PMID 27552350

WHAT IT FOUND

Magnetic glasses lifted a droopy eyelid, letting a patient with brain injury use an already deviated eye.

She reported seeing more of the room, and mobility and dressing support improved.

Key findings

01The magnetic device opened the right eye, and the patient reported seeing everyone in the room at once, with finger counting in the right field improving to 100%.

02During the initial week, wheelchair mobility improved from minimal assistance to supervision, upper-body dressing improved from moderate assistance to contact guard, and lower-body dressing improved from moderate to minimal assistance.

03At 2 months, the ptosis had recovered and Goldmann perimetry confirmed 30° of right visual-field expansion under binocular conditions.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

This is a case report, so it describes an individual case and cannot show that the device works for others. There was no comparison group, so the observed changes cannot be separated from natural recovery, therapy, or the patient's own effort. The occupational therapist supervised the trial and reported functional changes, and the authors discuss restored binocular vision or attention as possible contributors, so the eyelid magnets alone cannot be credited. The device was collected at discharge, and the patient was lost to follow-up until 2 months, so long-term use and safety were not assessed. At 2 months the ptosis had recovered, so it is unclear how much the device contributed versus natural recovery of the eyelid. Double vision and misperceived visual direction were not absent; the patient rarely reported double vision, and misreaching was observed, so the expanded field may be unsafe for some patients. The patient had severe cognitive deficits and required supervision, so results may not apply to more independent patients.

Declared interests

One author (A.M. Barrett) is employed by the Kessler Foundation, receives honoraria from emedicine, and receives research funding through the Kessler Foundation from NIH, NIDILRR, SPR Therapeutics, and DART Neuroscience. Houston and Paschalis helped develop the magnetic levator prosthesis but report no financial interest in the device or other technologies discussed.

The easy way to misread this

Do not conclude that magnetic glasses restore vision in hemianopia. The patient's hemianopia remained unchanged; the gain came from opening a deviated eye so it could see into the right field. This is a case report, not evidence that the treatment works.

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