About Us

Dr. Alvarez's team is the first to quantify how vision rehabilitation evokes neuroplasticity for people with convergence insufficiency, a visual dysfunction present in almost 50% of individuals living with traumatic brain injury (TBI). Our team conducted a study that quantified changes from vision rehabilitation through improvements in oculomotor behavior and functional MRI.

Persisting Symptoms after Concussion

After a concussion, many people experience headaches, blurred or double vision, eye strain, dizziness, and difficulty concentrating. When these symptoms persist beyond four weeks after injury, they can delay return to school, sports, driving, and work. Convergence insufficiency, a difficulty coordinating both eyes for near tasks, is one of the most common vision problems after concussion. In the CONCUSS randomized clinical trial, funded by the National Eye Institute, our team and clinical collaborators showed that once concussion-related convergence insufficiency persists, few patients recover on their own, whereas most improve with office-based vergence and accommodative therapy. Delaying treatment did not reduce its effectiveness, but it did delay return to activities.

Technology for Recording Eye Movements

Eye movements provide an objective window into these symptoms. Our laboratory designs instrumentation that measures eye movements precisely, including a custom haploscope that records vergence eye movements and accommodation simultaneously, and virtual reality headsets with integrated eye tracking that bring both measurement and therapy closer to the clinic and the home.

Understanding the Underlying Mechanisms

To understand why symptoms persist, we combine these measures with functional MRI. Using task-based and resting-state imaging together with computational models of brain networks, we study how concussion changes the networks that control eye movements, which changes accompany recovery with therapy, and whether brain network measures can help identify who is likely to recover.

This research is discovering how the brain retrains itself using its existing “real estate” to regain oculomotor function. It can be translated into better and more efficient treatments for people, resulting in more functionality in potentially a shorter period of time. The goals of this lab are to understand how the visual system interacts with the brain.