This article is a great example of the single-case design. Again, it isn’t the highest level of evidence, since it is only one individual case used with this treatment, but how often do you come across cortical blindness that you could get a large ‘n’? I have actually never had a patient with cortical blindness. So I think the single case design was a perfect pick for this topic.
And what an interesting topic! I personally, don’t know a thing about visual therapy, so I can’t really even compare the presented therapy strategy to the “typical” visual therapy. However, I would argue that knowing the “typical” isn’t necessary in this case, as it is easy to see that the treatment strategy they selected in this case most definitely worked!
There were 3 types of exercises they did following the methods outlined in the video:
- visual recognition of 3 geometric 2-D shapes as perceived by the right arm, finger
- visual recognition of 3 geometric 3-D shapes as perceived by the right hand
- visual recognition of 3 textures perceived by the right hand
The subject participated in these activities for 2 1.5 hour sessions daily for 8 months, in addition to other therapies.
The woman in the study started out being completely dependent for all activities of daily living (ADL) and a quadriplegic.
“… the subject was unable to maintain eye contact. Visual search was vague, untargeted, and focused only on areas of high light intensity, such as sunlight pouring through the window. She randomly and vaguely identified shapes or colors but could not identify objects. She reported ‘seeing as through a hole filled with fog.’ Cognitive impairments were related to visual perception and imagery, including difficulty in perceiving, constructing, processing, and remembering visual information. These impairments were apparent when describing objects in her room and when describing images from the past. She could not recognize people or watch television.”
And what a progression!
“… the subject maintained eye contact and recognized faces. She substantially improved her visual exploration skills and localized objects in her environment. She correctly described items in familiar and novel locations such as gardens and streets. She recognized objects and described their characteristics in terms of color, shape, size, material and surface. However, she excluded her most peripheral vision on both sides…. She described locations and objects from visual memory and even objects she had not seen for a long time. She watched television, read a wall clock, used her mobile phone, reach and grasped objects, and started to read children’s books.”
To me, that sounds like nothing short of a miracle, a miracle brought around through science and hard work on the part of several therapists, the participant herself and probably multiple other health care professionals and family members.