Sensory–motor integration and neuro-optometric rehabilitation: A narrative review of physiological basis and clinical evidence

Background: Vision is an active sensorimotor process involving visual information, eye movements, attention, and visually led action. These functions depend on distributed networks throughout the cortex, basal ganglia, cerebellum, brainstem, and vestibular system; therefore, brain injury may impair functional vision despite preserved visual acuity. This narrative review synthesizes studies on sensory–motor integration in neuro-optometry, differentiating known physiological pathways from diverse clinical rehabilitation findings across neurological disorders. Materials and Methods: PubMed, Embase, and the Cochrane Library were searched for literature from January 2020 to June 2026 using terms related to sensory–motor integration, neuro-optometry, ocular motor function, vision therapy, and major neurological conditions. Supplemented by backward citation chaining of foundational and landmark pre-2020 sources. Results: Physiological results imply linked binocular and oculomotor systems. Office-based vergence/accommodative therapy for symptomatic convergence insufficiency has substantial randomized-trial support for improving clinical convergence signs, with symptom benefit shown in CITT but not CITT-ART, whereas evidence for broader post-neurological vision rehabilitation is heterogeneous, limited by small samples, weak controls, and inconsistent functional outcomes. Eye tracking and virtual reality may provide objective assessment or rehabilitation; however, existing virtual reality research largely tackles post-stroke motor therapy rather than visual or oculomotor rehabilitation. Conclusion: Neuro-optometric rehabilitation should be individualized, impairment-based, and functionally oriented. Future research needs defined diagnostic criteria, objective eye-movement assessment, and randomized trials with functional and patient-reported outcomes that differentiate restoration, adaptation, compensation, and skill growth.