Neuro-Optometric Rehabilitation Association

Enhancing Neurological Recovery Through Vision Rehabilitation

Annual Conference

Registration is now open for the NORA Clinical Skills Pre-Conference (September 19–20) and the 28th annual General Conference (September 21–22) at the Embassy Suites by Hilton Scottsdale Resorts in Scottsdale, Arizona.

2019 NORA Clinical Skills Pre-Conference

Thursday, September 19

The Clinical Skills program provides 14 hours of continuing education and includes both hands-on and lecture style presentations with emphasis on integrated therapeutic approaches to rehabilitation. It offers three different levels which run concurrently and cannot be taken simultaneously.

Clinical Skills 1

DeAnn Fitzgerald, O.D.
Shannon McGuire, BHSc (PT)
Becky Moran, MSc (OT)
Susan Wenberg, M.A., D.C.

An introduction to neuro-anatomy and neuro-physiology in relation to traumatic brain injury rehabilitative care, with a specific focus on the principles and application of Neuro-Optometric Rehabilitation, including strategies and practices on lenses, prisms, etc. with vestibular and proprioception dynamic movement.

Clinical Skills 2

Tracy Ammann, OD
Janet Berthiaume, OTR/L, CDRS, FNORA
Raquel Munitz-Goldfeder, MS
William V. Padula, OD, SFNAP, FAAO, FNORA
Vincent R. Vicci, Jr. OD, D.P.N.A.P., F.N.O.R.A

Provides advanced applications of general rehabilitation and Neuro-Optometric Rehabilitation.

Advanced Courses—Attendees may choose one workshop in AM

The Missing Link: Visual and Vestibular Dysfunctions Following Concussion (mTBI)

Rebecca Bliss, PT, DPT
Ashley Reddell, OD, FCOVD

This interactive course will work to bridge the gap between visual and vestibular impairments commonly seen following concussion injury. Attendees will participate in an in-depth discussion of techniques used to evaluate and treat dysfunctions in both the visual and vestibular systems. We will highlight the importance of the multidisciplinary approach to better integrate the visual and vestibular systems in a patient’s daily life and provide case examples to encourage understanding.

Resiliency Through Reconnections: Reflex Integration Following Brain Injury

Alex Andrich, OD, FCOVD
Patti Andrich, MA, OTR/L, COVT, CINPP

This two-hour Advanced course will detail what primitive reflexes (PR) are, why they reemerge following a brain injury, how they affect sensory-motor integration and how integration techniques can be used in the treatment of brain injuries. Participants will learn how to effectively screen for the presence of PRs and how to reintegrate these reflexes to improve patient outcomes. Additionally, current research regarding PR integration and brain injuries will be highlighted and cases will be presented.

Advanced Courses—Attendees may choose one workshop in PM

Differential Diagnosis of Dizziness using Vestibular and Cerebellar Tests

Charles "Chuck" Plishka, PT, DPT, NCS

This course briefly reviews cerebellar and vestibular anatomy, and then reviews tests of each system. The HINTS Plus Examination (Head Impulse, Nystagmus, Tests of Skew, and Hearing) will be instructed to identify those with possible strokes. Signs and symptoms of vestibular dysfunction will be contrasted with vestibular signs indicating central deficits. Labs will offer attendees the opportunity to practice learned tests.

Optometric and Physical Therapy Neuro-Rehabilitation to Rectify Body Self Organization

Larry B. Wallace, O.D., Ph.D.
Michal Niedzielski, MPT, PRC

This workshop will introduce the attendee to the rehabilitation field for treating people with chronic pain problems, balance, trauma, sport's injuries and concussions through the integration of visual and physical therapies. Emphasis will be placed on the diagnostic and treatment protocols based on key principles of body network self-regulation.

Friday, September 20

Clinical Skills 1

Continued from Day 1

Clinical Skills 2

Continued from Day 1

Advanced Course

The Importance of a Mind-Eye Connection

Deborah Zelinsky, OD, FNORA, FCOVD

This seven-hour advanced symposium presents the basic foundation for a  21stcentury optometric practice. by learning how to stimulate neuroplasticity in a logical way. The format will be an enjoyable, interactive hands-on immersion into how our optometric treatments affect posture (the “WHERE am I?” pathway) and body biochemistry (the “HOW am I?” pathway). When those pathway measurements are combined with our classic aiming (“WHERE is IT?”) and focusing (“WHAT is IT?”) pathways, sensory integration is enhanced. Overall emphasis will be on actual cases rather than science, with the goal to have participants being able to evaluate patients in an expanded way the next day.


The NORA General Conference offers up to 15 additional hours of continuing education for optometrists and allied professionals.

Saturday, September 21

Scoring for Success: Charting Tips to Maximize Insurance Reimbursement

Denise Helle, CPOC

This is the third year that Denise Helle has provided a free seminar about billing and coding at the NORA conference. This year, Denise will teach attendees how to score their own notes to determine whether they meet billing requirements. She will provide insider secrets to maximizing insurance reimbursement and surviving insurance audits. Denise is also available for free one-on-one consultations during the conference.

Enhancing the Athlete's Visual System: An Introduction to Sports Vision Performance

Matthew Roe, OD, FAAO

Sports Vision is a fast-growing field geared towards providing quality eye care and performance enhancement for the athlete. This course is designed to serve as an introduction into this field, focusing on the visual skills necessary for an athlete’s success and how to appropriately evaluate and train each skill. Various training techniques will be showcased through both live demonstration and pre-recorded video.

The Functional and Nutritional Medicine Approach to Brain Injury – A Focus on Restoring Endocrine Mitochondrial Function

Paul Hrkal, BKin, ND

Concussions continue to be hotly debated public health issue. New research is being published at a torrid rate challenging clinicians to integrative the new information into their practice. In this lecture, Dr Hrkal will condense and summarize the latest literature on the pathophysiology of Traumatic Brain Injury (TBI) as it applies to an integrative and functional medicine focused practice. Through the lens of dysfunctional mitochondrial, endocrine and immunological function. Dr Hrkal will review the latest research on pharmaceutical, nutritional and supplemental interventions. This will include practical strategies for dietary changes, sleep hygiene and nutrient dosing. He will explore case studies for brain resilience, acute care and addressing post-concussion syndrome.

A Multidisciplinary Approach to Concussion Care: “Working Together”

Tanya Polec, OD, FCOVD
Mo Mortazavi, M.D.

Using an interdisciplinary team approach, we will explore the relationship of concussions and the visual system.

The following will be discussed; recognizing concussion related visual deficits, accommodations and treatments, protocols for clearing patients, current evidence regarding concussions and vision, and a multidisciplinary case review.

Manual Therapy as a Key Component for Multidisciplinary Concussion Care

Kyla Demers, B.Sc., CAT(C), DO

This presentation will explore the key anatomical structures and systems potentially affected by a concussion as addressed in complementary alternative therapies. Direct or indirect impact, whiplash, repetitive impacts can lead to mobility restrictions of the head, neck and thorax. These restrictions can greatly influence many concussion related symptoms and influence a person's quality of life. We will discuss how to integrate manual therapy into the concussion care team, as well as which therapies can be used for different structures. The session will include a demonstration of key cranial techniques used in osteopathy.

Sunday, September 22

“Diagnosis before Prognosis: Going Beyond Visual Acuity in Visual Rehabilitation”

Dr. Patrick Quaid, Optometrist, FCOVD, PhD

Dr. Quaid will provide an update on new research data in concussion management and advise how different healthcare professionals should interact in mTBI cases and, most importantly, in what sequence. Dr. Quaid will discuss management, not only from a visual standpoint, but also in terms of how the visual rehabilitation is combined with other forms of rehabilitation such as vestibular rehabilitation, cervicogenic interventions and psychological management. Dr. Quaid is known for showing fascinating video recordings of his cases to highlight his research points and always bases his talks in evidence-based data. He will also show that the difference between an average healthcare professional and an excellent one is that the latter simply knows when to get others involved and that it does indeed “take a village” to manage these cases.

“Why the Eyes are the Liars”: Diagnosis & Management of Otic Symptoms of TBI

Brenda Berge, D.Aud., F-ADA

Seven of the most common complaints of TBI and concussion, once historically referred to in the otic literature as cervico-encephalic syndrome, include but are not limited to: vertigo, dizziness, disequilibrium/imbalance, tinnitus, sound sensitivity, hearing changes / loss, and otalgia/ear pressure. Patients are rarely referred for audiologic/otologic exams for these Audio-Vestibular Nervous System (AVNS) symptoms. Clinical nomenclature is important, human equilibrium is the study of balance that involves: vestibular system, oculomotor-binocular vision system, and the proprioceptive system for the CNS and cerebellum to integrate in order to maintain balance. The vestibule is the sensory end organ of the ear. Therapists performing screening tests for VOR gain (vestibulo-ocular reflex) disparity often results in vestibular therapy (VRT) in the absence of a vestibular diagnosis. Crucial for the ‘dizzy’ patient and VOR is diagnosis and management of the binocular-oculomotor system (ie. PTVS, Convergence Insufficiency, etc) and diagnosis of the vestibular system (ie. high frequency uncompensated vestibulopathy, vestibular migraine, Mal de Mer, etc.). The visual system is the external referenced sensory input that most often usurps what should be the primary internally referenced sensory input from the vestibules causing the CNS (mother brain) to interpret the error message: oscilopsia (from the lying little brother, the eyes), causing the symptom: dizziness.

The Critical Importance of Optometric Involvement on the Rehab Team

Curtis R. Baxstrom, MA, OD, FCOVD, FAAO, FNORA

The optometrist is a critical part of the rehabilitation team. A vision screening or the recognition that there is a visual component present should require an immediate referral for a comprehensive vision examination. This will address possible ocular and neurological health concerns and then lead to a more accurate diagnosis of the specific visual issues that need to be addressed by the provider and/or team. Next, appropriate treatment is considered which could include further evaluation(VEP, etc.), visual hygiene, lenses, prism, selective occlusion, tints/filters, neuro-optometric rehabilitation and consideration for further referrals to other disciplines. We will review the six subtypes of concussion described by the University of Pittsburgh Medical Center and how vision can play a role in all of them. We will also present cases demonstrating concerns of treatment based upon minimal diagnostic information and how it may delay the best outcomes in rehabilitation. Prognosis should be based upon an appropriate diagnosis by healthcare professionals operating within their respective scope of practice.