Pattern one
The patient with limited mobility
Getting to an appointment requires help, transport and most of a day. Remote delivery is often the difference between having a programme and not.
Visual rehabilitation after a stroke runs for four to eight months and depends on daily practice at home. Asking a family in Mumbai to bring someone with limited mobility across the city weekly for that period is asking for a programme that stops. We deliver it at home, where the practice happens anyway.
For neuro rehabilitation, delivering the programme in the patient’s own space is not a compromise. It is frequently better.
Scanning training aims to change how someone navigates a real environment. Practising it in their own kitchen, on their own stairs, with their own doorways, transfers directly. Practising it in a clinic room requires an additional generalisation step that many patients, particularly those with neglect, manage poorly.
The same applies to reading retraining, which should use the material the person actually wants to read, and to safety work, which should use the hazards that actually exist in their house. A therapist watching over video can see the real environment and adapt the programme to it, which a clinic appointment cannot.
Skills learned in a clinical setting do not automatically transfer to daily life, and patients with neglect or field loss are particularly prone to this. Training in the environment where the skill is needed removes the transfer step, which for some patients is the difference between a programme that changes their day and one that only changes their scores.
A telehealth programme delivered into the home environment, with a family member supervising daily practice.
First appointment
The full assessment taken in one extended session where the patient can tolerate it, because for this group a second intake appointment is frequently the one that does not happen.
Prescription check
Correction and any occlusion or prism confirmed immediately and coordinated with the existing eye care provider rather than duplicating their work.
Weekly work
Fortnightly supervised sessions and short daily practice run entirely from home, since travel itself is a substantial symptom trigger in post-injury patients.
Review and step down
A defined review point against the functional goals, with an explicit decision to continue, change or conclude rather than an open-ended programme.
Mumbai and the MMR
Mobility limitation plus a Mumbai journey makes weekly clinic attendance a serious undertaking, and a months-long programme rarely survives it.
Pattern one
Getting to an appointment requires help, transport and most of a day. Remote delivery is often the difference between having a programme and not.
Pattern two
An adult child coordinating care around a full-time job. Evening and weekend sessions make supervision realistic.
Pattern three
Lifts, corridors and stairwells with specific navigation hazards. Training in the actual environment is more useful than generic scanning practice.
Across Mumbai and the MMR we work with families in
Formal field testing needs equipment and one local appointment. We specify the test rather than requiring a general referral.
Reluctance to move independently is often read as loss of confidence. Frequently it is a rational response to an unassessed visual deficit.
Almost all of it, and for a patient with limited mobility this is usually the only realistic route to rehabilitation at all. Assessment, scanning training, oculomotor work and reading retraining are all delivered over video with a family member assisting. There is a clear exception: formal perimetry to map a visual field needs equipment, and we name that specific test so one local appointment covers it. Everything else happens in her own home, which for scanning training is an advantage rather than a compromise.
Fifteen to twenty minutes on most days, and someone present at the weekly session. That is a real commitment and worth planning honestly before starting. It does not have to be the same person each day — several families split it between siblings, a spouse and a domestic helper who is briefed on the technique. What matters is consistency rather than who provides it. We would rather set the programme at a level your household can sustain than design something ideal that lapses in month two.
Coverage varies and we cannot promise anything on that. What we do provide is clinical documentation with objective findings, functional impact and a treatment plan, which is the material most insurers ask for and which many families lack when a claim is refused. Our fees are stated before you commit, so you can weigh the decision with the actual numbers rather than an estimate. If cost is the binding constraint, tell us and we will discuss what a shorter, more targeted programme could realistically achieve.
Often it improves substantially in the first three to six months, and that is a genuine reason not to intervene surgically too early. It does not always resolve completely. During that period the practical priorities are comfortable single vision, by occlusion or prism, and preventing the secondary problems that come from avoiding one side. If a stable deviation persists beyond six months, the options widen and a surgical opinion becomes reasonable.
Frequently, and reading is often the function patients most want back. The difficulty is usually mechanical rather than linguistic: the eye movements that carry the gaze along a line, and back to the start of the next one, have been disrupted. Training those movements directly, with text-based tasks graded for length and spacing, produces measurable change. Where the difficulty is aphasic rather than visual, that belongs with speech and language therapy.
Two Clinics · Seven Telehealth Cities
Delivered to Mumbai and the MMR by secure telehealth — in-clinic rehabilitation in Chennai and Hyderabad.
Their kitchen, their stairs, their doorways. A home-delivered programme removes the transfer step and removes the journey. Across Mumbai and the MMR.