Neurobiology, visual impairment and rehabilitatives interactions

If low vision is caused by eye diseases, therapies will be managed by ophthalmologist with assis- tants and other low vision professionals. Visual rehab centers are not a lot and they are not very efficient. Usually, in these centres doctors just try to find optical or electronic tools that al- low, through the growth of the images, patients to be autonomous in reading. Visual rehab teaches to low vision patients some compensatory and independent strategies (distance, growth, light, string of reading scan). Based on our study, only 30% of visual rehab centres in Italy perform visual rehabilitative tech- niques supporting the prescription of optical tool (neuromodulation, neural fotostimulation, visual training). There are even less centres where cel- lular regeneration and reparation techniques are performed, namely addressed to the retina stabili- zation and neurostrenthening. If low vision comes with neurological problems (as consequences of strokes, Parkinson, multiple sclerosis), ophthalmologists step aside and neu- rologists come to play, but they barely take care of visual aspects. All of us know that retinal images are neuroelec- tric impulses transmitted by the cortex to guar- antee vision. Anyway, neither ophthalmologist or neurologist analyse any diseases considering that. So, we think that eye and brain should be studied with an ophthalmogical and neurological com- bined approach. Therefore, new concepts end efforts are necessary to develop better strategies of sensorial compen- sation, exploiting the brain proper ability to adapt to wound. The therapeutical misunderstanding comes from the fact that if a patient affected by maculopathy can not use his own residual vision, he will be told that glasses are useless because the wound of the retina is irreversible, or if a retinitis pig- metosa patient asks for a better vision, he will be answered that there is nothing to do for that disease. This attitude shows a gap concerning the impact that a lot of co-factors can have on a level both ocular and cerebral. These co-factors, if correctly stimulated, are able to improve visual conditions of the patient. Among all the scientists who studied these reha- bilitation chances, the most active is Professor Bernard Sabel of Magdeburgo (3, 4). Especially, Sabel pointed out the necessity of bet- ter understanding the three-way mutual inter- action of eye and brain with the cardiovascoular system (Pict. 1).