Category Archives: Concussion and Traumatic Brain Injury

I ♥ NORA

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We just returned from another NORA conference and my mind is reeling!

What is NORA? NORA is the Neuro-Optometric Rehabilitative Association, a multi-disciplinary organization dedicated to advancing the art and science of rehabilitation of the neurologically and cognitively injured and disabled survivor population and their families. NORA emphasizes treatment modalities designed to optimize the frequently neglected visual-motor, visual-perceptual and visual information processing dysfunction in the neurologically affected person. Integration of Neuro-Optometric treatment modalities maximizes the potential of the rehabilitation team within a multidisciplinary approach. For more information, please visit NORA’s website.

I’m so fortunate to have this group of colleagues to learn and share ideas with within the vision rehabilitation world.
This year’s conference, in Cary, NC, was once again amazing and I’m heading home with a million strategies to implement to help our patients achieve a better and faster recovery. Here are some highlights:

Dr. Nathan Kegel: Concussion Management-ImPACT and Neuro-Rehabilitation

Dr. DeAnn Fitzgerald: ImPACT Testing and Optometric Management of Concussion

Dr. Stuller: Psycho-Neuro Immunology. Clinical application of an emerging field in medicine.

Cavin Balaster, TBI Survivor: Lights, Coma, Action! Adventures in Brain Injury (see photo below)

Dr. Lewerenz: Management of Hemianopsia with Prism and Visual Rehabilitation

Dr. Barry Kavanaugh: Understanding, Identifying and Remediating Visual Multitasking Dysfunction.

Our very own Dr. Pam Wendlandt: Poster session (see photo below)

Amazing presentation by Dr. Stuller on the psycho-neuro-immunology triad. Facinating!

Amazing presentation by Dr. Stuller on the psycho-neuro-immunology triad. Fascinating!

Dr. Wendlandt, Cavin "Bounce" Balaster and me at NORA

Dr. Wendlandt, Cavin “Bounce” Balaster and me at NORA

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Photo of world-renowned Dr. Curt Baxstrom and NORA President, Dr. Jill Schultz and Dr. Pam Wendlandt posing with her incredible poster

 

 

Presenting my fellowship publication while modeling my OKN shoes.

Presenting my fellowship publication while modeling my OKN shoes.

 

ImPACT Training: Measuring Neurocognitive Recovery from Sports Concussion.

ImPACT Training: Measuring Neurocognitive Recovery from Sports Concussion

 

 

 

 

 

 

 

 

 

 

 

I have now completed by fellowship in NORA, which means I will have more letters after my name (I know, it’s getting obnoxious!) and have completed a program of skill mastery to better help those with visual difficulties related to concussion and acquired brain injury. Please watch for news of my article to be published in a rehabilitation journal.

I feel so grateful to have this group. There is hope for those impacted by acquired brain injury! If you have questions about Neuro-Optometric Rehabilitation please do not hesitate to contact me.

Jill K. Schultz, OD, FAAO, FCOVD, FNORA

Hillary Clinton suffers from Vision Issues Post Brain Injury

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Hillary wearing Fresnel prism, an indication that she is suffering from double vision.

Visual Symptoms in patients following an ABI or Concussion:

  • Double vision
  • Light sensitivity
  • Poor tolerance to fluorescent lights
  • Headaches
  • Blurry vision
  • Dizziness or nausea
  • Attention or concentration difficulties
  • Staring behavior (low blink rate)
  • Spatial disorientation
  • Loss of place when reading
  • Comprehension problems when reading
  • Visual memory problems
  • Pulls away from objects when they are brought close to him/her
  • Bumps into objects when walking
  • Poor balance or posture

What is Neuro-Optometric Rehabilitation?

In addition to working with adults and children with learning related vision issues, strabismus and convergence issues, we have begun seeing more patients with vision issues stemming from concussions, strokes or other head injuries. These patients are often left with vision issues following their treatments but not often given solutions to alleviate those symptoms!

Post concussion vision disorders:

As optometrists, we often see adults and children with a history of concussion or head traumas. Because vision is pervasive through the brain, it is extremely common to have visual issues after a brain injury or concussion.

Fortunately, many of these conditions and symptoms are well-managed or treatable. Treatments include lenses, spectacle prism, Fresnel prism, tints, home therapy techniques, in-office vision therapy, education and collaboration with other medical professionals such as occupational therapy, physical therapy, speech/language therapy, etc. In my experience, the vast majority of post-concussive patients have an immediate improvement in comfort with a change in lens prescription.

Some symptoms subside with time, but many do not. Studies by Cohen demonstrated vergence difficulties were essentially the same in the acute phase compared to three years later. This and other studies show that there is no reason for patients to wait (suffer) to get help.

My recommendation is for patients with concussions, especially those with visual symptoms, to be seen as soon as possible since symptoms and untreated vision issues can reduce quality of life and outcome of rehab.

You may have heard about Hillary Clinton’s recent TBI/concussion after a fall this December. It appears that she is receiving treatment for diplopia as she is sporting a Fresnel prism on her lenses in recent photographs. Hopefully, she is receiving visual care from an optometrist so she can make a full recovery.

If you or someone you know is has sustained a concussion or brain injury, please do not hesitate to contact our office at 763-241-1090 or email drschultz@

thechildrenseyedoctor.com if you have any questions in general about Neuro-optometric rehabilitation or a specific patient case. We love helping our patients reach their maximum potential.

Thank you,

Jill Schultz, OD, FAAO, FCOVD