Neuro-Optometric Rehabilitation Association

Enhancing Neurological Recovery Through Vision Rehabilitation

2022 Annual Conference

Thursday, September 8

Morning sessions will run from 8:00 AM – 11:30 AM (with ½ hour break). Lunch will be served from 11:30 AM until 1:00 PM. Afternoon sessions will run from 1:00 PM – 4:30 PM (with ½ hour break). Exhibit Hall will open at 4:30 PM and Welcome Reception will run from 5:00 PM – 7:00 PM.

Foundations of Neuro Optometric Rehabilitation (a.k.a. Clinical Skills Level 1)

  • Katy Coleman, OTR/L
  • Melissa Zarn, OD, FAAO
  • Morning session (Part 1) - COPE Course ID: 79356-FV
  • Qualified Credit: 3.00 hour(s)
  • Afternoon session (Part 2) 3 hours – COPE Course ID: 79357-FV
  • Qualified Credit: 3.00 hour(s)

This course will provide a foundational understanding of the role of neuro-optometric rehabilitation for vision disorders associated with neurological impairment. An overview of structure to function mapping in the brain, visual processing and the impact of neurologic impairment, and the key components of Neuro Optometric Rehabilitation (NOR) will be reviewed. This course is designed to introduce key concepts in NOR to practitioners who have limited experience with NOR. This course will also benefit anyone starting the NORA Fellowship process preparing to complete the Level 1 open book questions and NORA concepts presentation.

Clinical Applications of Neuro Optometric Rehabilitation (a.k.a. Clinical Skills Level 2)

  • Clinical Applications of Neuro Optometric Rehabilitation Part 1 (Padula/Munitz-Goldfeder)- COPE Course ID: 79332-FV
  • Qualified Credit: 3.00 hour(s)
  • Clinical Applications of Neuro Optometric Rehabilitation Part 2 (Padula/Munitz-Goldfeder)- COPE Course ID: 79333-FV
  • Qualified Credit: 1.00 hour
  • Clinical Applications of Neuro Optometric Rehabilitation Part 3 (Vicci) - COPE Course ID: 79517-FV
  • Qualified Credit: 2.00 hour(s)

This course will expand your ability to implement treatment for patients who present with neurologically based vision challenges. A series of case histories including the patient’s history, initial evaluation, diagnosis, treatment plan and therapy program will be reviewed. You will leave feeling more proficient and confident with beginning or continuing to treat those who will benefit from Neuro-Optometric Rehabilitation.

Extended Concepts in Neuro Optometric Rehabilitation (a.k.a. Advanced Clinical Skills)

A Systematic Method for Prescribing Lens/Prism Corrections

Spatial sense is the way we can establish a stable, constant relationship with our 3D surroundings. If a patient is not oriented in space at the subcortical level, then spatial organization, localization and identification will be difficult & altered.

Understanding the components of spatial sense and the neurology of the bimodal visual processing, we can systematically test a patient’s perception of space. Understanding the mathematical properties of how prisms can cause a response change with our patients and using mathematical computations, we can calculate a starting prism correction to “recalibrate” visual processing.

Dr. Mackowsky will discuss her testing strategies and methods of interpretation to determine prism corrections that will remediate patient’s symptoms.

Visual-Vestibular Integration Training in Concussion Management

This workshop focuses on vestibular assessment and treatment approaches post-concussion for ages 14 and older. Participants will have access to the Concussion Clinical Profiles (CP) Screen, which extends on previous symptom inventory questionnaires by evaluating symptoms more specifically to better identify clinical profiles and target clinical care. Participants will also learn how to transfer findings from concussion-related balance assessments into treatment progressions, implement novel treatment approaches in vestibulo-ocular reflex training, and have exposure to clinical pearls in both current and future trends in concussion management.

Friday, September 9

Lenses/Prism Symposium

This all-day Clinical Skills symposium will demonstrate practical uses of lenses, compensatory and yoked prism, filters and selective occlusion as powerful tools for the optometrist to use in the collaborative rehabilitative treatment of patients with traumatic brain injury, degenerative disorders, developmental delays, tumors and stroke. Optometrists and therapists will learn through video case studies how the application of these tools are used to treat postural instability, double vision, dizziness and disorientation, photophobia, visual midline shift, visual field loss, visual spatial inattention, ambient/focal visual dysfunction, nystagmus, and cranial nerve palsies. Each speaker will walk through their thought process in determining prescriptions and therapy to improve the lives of their patients.

8:00 AM – 8:50 AM

Vision in the balance

The purpose of this lecture is to demonstrate how vision plays an essential role in the progress of rehabilitation. Many patients have significant visual symptoms that are interfering with their rehabilitation progress. A demonstration through cases and general education will provide insight of the use of lenses, prism, and partial occlusion to help our patients better achieve their rehabilitation goals.

9:00 AM – 9:50 AM

Optometry through a Neuro-Developmental Lens

Vision problems associated with neurological disease, trauma, metabolic and congenital conditions can adversely affect the lives of both children and adults and yet are often missed in general eye examinations.  Evaluation and treatment procedures to help patients with problems with balance, dizziness, body awareness, photosensitivity, visual processing, anxiety, and other functional vision problems will be discussed and demonstrated through case studies of both adults and children of varying developmental abilities.

BREAK 9:50 AM – 10:30 AM (Exhibit Hall open)

10:30 AM – 11:20 AM

Tools of the trade: Uses of lenses, prisms, filters and occlusion in rehabilitation treatment

Patients with developmental and neurological conditions can benefit from the unique tools that optometrists can use in the functional rehabilitation to improve the patient's quality of life. This lecture will show methods used to treat a variety of common neurological symptoms such as dizziness, postural distortions, anxiety, and double vision. Evaluation and treatment of neurological vision problems will be discussed through case studies and video demonstrations.

11:30 AM – 1:30 PM

Exhibit Hall Open/Lunch Served

1:30 PM – 2:20 PM

Under the Surface: Vision and Mental Health

The purpose of this lecture is to demonstrate how vision and mental health problems are often intertwined. In many cases, patients are symptomatic for years because their visual systems are overlooked. We will review cases where mental health problems are a primary symptom of the patient's underlying visual condition. We will explore the use of lenses, prism, selective occlusion and other treatments to improve more than just the visual system. Finally, patients will share their before-and-after experiences.

2:30 PM – 3:20 PM

Retinal Neuromodulation: A New Name to Using Lenses and Prism to Aid Rehabilitation/Recovery

While the eyes are referred to as the "window to the soul", the retina is the window into the patient’s nervous system, as well as his/her general health. The purpose of this lecture is to explore how using lenses and prism to modify light on the retina helps the patient process and integrate visual information in a different way to aid their recovery. Over the last 30-40 years, neuroscience research has not only proven decades-old theories correct, but gives us a better understanding of how to use these valuable tools to achieve better patient outcomes. Patient cases will be presented to illustrate the concepts.

Exhibit Hall Open
3:30 PM – 6:30 PM
NORA General Meeting
4:00 PM – 5:00 PM
Poster Session Opens
5:00 PM

6:00 PM - 9:00 PM

NORA Fellowship Presentations: Neuro-Optometric/Brain Injury Rehabilitation Lectures & Case Reports
  • Moderators: Derek Tong O.D. F.N.O.R.A, Nancy Mackowsky O.D. F.N.O.R.A, Tonya Umbel O.D. F.N.O.R.A
  • Presenters: Various NORA Fellowship Level 1 Candidates (10-12 minutes short lectures) and Level 2 Candidates (18-20 minutes case reports)
  • This course is FREE to all NORA 2022 attendees; no separate registration is required
  • This course is not for COPE credit
  • Lecture and case report topics will be posted at each of the 2 rooms on the day of the presentations
  • Presenters check-in 6:00-6:15 pm

Saturday, September 10

8:00 AM – 8:50 AM

Differentiating traumatic vs developmental oculomotor dysfunction and its role in managing victims of domestic violence.

This course provides a comprehensive review of the diagnosis of oculomotor dysfunction and its role as an objective biomarker for TBI.  It will utilize cases of developmental and traumatic etiology to compare and contrast various presentations, to aid the provider in suspicion of traumatic etiology when not divulged by the patient in the case history.  It will further detail the role of the optometrist in how to co-manage patients who are victims of domestic violence and next steps for the provider to aid in patient advocacy and safety.

9:00 AM – 9:50 AM

Sports Related Concussion Management in Wheelchair Athletes

Interest in concussions in the adaptive sports population is growing in recent years but there continues to be a large gap in knowledge and guidelines on how to evaluate and treat a sports related concussion (SRC) in disabled athletes. Literature review has abundance of SRC related research in the able-bodied sports. However, there was essentially no scientific research specific to the SRC in adaptive sports athletes

We gathered experts from around the world to provide a thorough literature search in SRC and created a handbook on this topic. This handbook is written for any member of the wheelchair sporting community to better understand a concussion and the process of evaluation and return to play. As there are challenges in evaluation of SRC in this population, there is risk of an athlete returning to play without proper evaluation. This may result in further risk of subsequent concussive injury such as second impact syndrome or other musculoskeletal injuries.

The presentation will highlight the focal points of each chapter and bring forth the current practices in evaluating SRC in wheelchair athletes and/or present the challenges, gaps, and future needs utilizing the first book on this topic authored by the presenter and colleagues.

10:00 AM – 10:30 AM

New evidence for nutrition-based strategy to minimize effects of concussion / TBI

The potent antioxidant and anti-inflammatory carotenoids lutein, zeaxanthin, and meso-zeaxanthin accumulate in brain tissue, where they have been recently demonstrated in animal models to have significant protective benefits post-brain injury. A summary of the findings of these studies will be presented, and attendees will learn about additional benefits of these nutrients. Lastly, practice implementation concepts will be discussed.

10:30 AM – 11:00 AM BREAK (Exhibit Hall Open)

11:00 AM – 11:50 AM

Unfortunately, Dr. Gary Asano is unable to attend the conference. We are working with him to record his presentation, “Low Vision Rehabilitation-Far More Than Visual Acuity!” and make it available to all attendees following the conference. As it will be remote and not interactive, it will not be for COPE credit. We apologize for the inconvenience. In place of his presentation, we are offering the following presentation. Because of the late change, it will not be for COPE credit

Remapping to rehabbing, Vision is built on motion. We are wired to fire!

DeAnn M. Fitzgerald, OD

This course is not for COPE credit.

Why does one person recover and the other not? During this presentation, Dr. Fitzgerald will explore new technologies and therapies. Fixing the repair process is the key.

Neurological issues with the brain lead to neurological issues with the body.

12:00 PM – 2:00 PMLunch/NORA Awards Banquet (Exhibit Hall open)

2:00 PM – 2:50 PM

Visual Evoked Potential (VEP) “The Final Frontier”: What Does the VEP Tell Us?

The visual evoked potential (VEP) has been used for clinical assessment for almost 100 years. The first tests were to determine the integrity of the optical pathway for each eye for a patient with optic neuritis. The tests assessed afferent nerve function. While the first tests were strobe flash, in the 1970’s the pattern reversal was provided but still for the same purpose. The medical model applied at that time and that is still applied today, adheres to determining if the optic nerve and pathway is healthy. Little attention has been given to the visual process in the brain and the effect of compromise and dysfunction within the visual process on VEP results.

In this presentation, we will explore the visual process within the brain and the clues to de-coding the language that the brain speaks to us through the P-100 pattern reversal response. A bi-modal visual processing model will be applied yielding new information about neurological compromise from concussion of the visual process. In addition, we will look at psychiatric conditions and what the VEP tells us about dysfunction in visual processing.

3:00 PM – 3:45 PM

Telemedicine: Maintaining Your Practice Virtually

The COVID-19 pandemic has dramatically changed how outpatient care is delivered in health care practices. Not all patients can come to the office for therapy or review of therapies, creating a need for health care practitioners to embrace new ways of thinking, operating, and providing care to improve the quality and way they interact with patients and their caregivers. During this presentation, Dr. Fitzgerald will share their experiences in operating virtually, including use of diagnostic and treatment tools, as well as advice on billing and coding for services.

3:45 PM – 6:00 PM

Talk & Trial

Take advantage of this opportunity to spend dedicated time with our exhibitors, learning about and gaining first-hand experience with a vast array of products, programs, and services that can help you build and enhance your practice.

7:00 p.m. – 9:00 P.M. Student Reception

Sunday, September 11

8:00 AM – 8:50 AM

And Sometimes “Why”: Understanding Brain Functions to Better Identify Why Neuro-Rehabilitation Works So Successfully

Having gone through many courses that taught vision rehabilitation, Dr. Thomas was fascinated by the changes that we could make in our patients’ vision and lives. However, her strong desire, to understand why neuro-optometric tools had such an impact never seemed to be satisfied. When she started to better recognize brain anatomy and physiology, the patterns appeared and answered many of the why’s. She wants to share those patterns with you so you can not only better understand your patients’ brains, but also so you can more quickly and efficiently treat them and explain to them the process along the way.

This lecture will include both the scientific names of the brain so you can do more of your own research and also stories and mnemonics to help keep your brain engaged and help you retain what you have learned longer. She will review the gross regions of the brain, how they contribute to neural function, and also treatment options that can stimulate or calm each region.

9:00 AM – 9:30 AM

Working Together to Unravel the Complexities of Persistent Concussion Symptoms (PCS)

While acute concussion involves a rapid neurometabolic cascade of events mainly isolated to cerebral function, persistent concussion symptoms seem to be a more systemic injury that affects multiple systems throughout the body. It is this complexity which makes these cases both so fascinating and often so difficult to treat. This presentation will summarize the past 10 years of evidence in order to simplify our understanding of PCS and describe how a collaborative multidisciplinary approach is necessary for improving patient outcomes.

9:40 AM – 10:30 AM

Visual Snow Syndrome: What the research tells us?

Visual Snow Syndrome is a neurological condition that impacts an individual’s vision, hearing, and quality of life. Patients see flashing lights, flickering dots, and static, which obstruct their visual field 24/7. There is no relief for them, even when their eyes are closed. It causes many other debilitating visual & non-visual symptoms. Once thought to be rare, Visual Snow affects an estimated 2-3% of the world’s population. Currently, there are no standard successful treatments for those suffering with VSS. In this presentation, Drs. Shidlofsky and Tsang will discuss their research on Neuro-Vision rehabilitation as a potential treatment for VSS and present some case studies to demonstrate the effectiveness.

10:30 – 10:45 Meeting adjourned