Clinical Skills and Fellowship Program

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This program was developed for the membership of NORA to initiate, develop and support the highest level of competence in clinical abilities and scientific knowledge in the field of Neuro-Optometric Rehabilitation. This process leads to a Fellowship (FNORA) within the Neuro-Optometric Rehabilitation Association. It is not a certification process but rather a growth process designed to enhance the clinical competency of health care providers who treat patients who have suffered traumatic brain injury or neurological insults.

NORA Clinical Skills and Fellowship Program is made up of the Curriculum and Fellowship Committees, currently chaired by Drs. Cathy Stern and Wid Bleything. All those involved are dedicated to the original goals developed by Drs. William Ludlam and Thomas Politzer for a multi-level program to enhance knowledge and skills of those working in the fields of rehabilitation. Upon completion of all three levels of the program, participants will be presented with the designation of FNORA - Fellow of the Neuro-Optometric Rehabilitation Association.

Individuals may attend the Clinical Skills Level I and Level II courses without enrolling in the program leading to Fellowship. These courses are invaluable for developing your knowledge of Neuro-Optometric Rehabilitation and consisitently receive high marks from all who attend.

The Fellowship requirements include completing Curriculum Courses I and II along with specific requirements for Fellowship Levels 1-3.  For Level 1: pass a written test and give a 10-minute topic presentation at a NORA conference.  For Level 2: submit two case reports and give a 20-minute presentation of one of your cases.  For Level 3, you must have a peer-review article or book chapter published along with a 30-minute presentation of your paper or book chapter. There is a time limitation (currently 10 years) to complete the Fellowship process.

To begin the NORA Clinical Skills and Fellowship Program, a participant must:

 1. Be a member in good standing with NORA and remain current on dues during the entire process.

 2. Submit the Clinical Skills and Fellowship Program Application to NORA. (see link at top of page)

     Now you are ready to complete Curriculum courses I and II along with Levels 1-3 leading to Fellowship.


Overview of Curriculum Course I

Curriculum Course I covers a participant's understanding of background scientific literature that is at the core of Neuro-Optometric Rehabilitation.

Course Learning Objectives:

Prevalence of Brain Injury

1. Describe the incidence, prevalence and epidemiology of brain injury. 
2. Describe the ICF model, 4 Pillars of Function and Patient Centered Care concepts of rehabilitation.

Understanding the Nervous System, the Brain and Brain Injury

1. Describe the function of the autonomic and sympathetic nervous systems. 
2. Identify basic brain structures and functions.
3. Describe brain-behavior relationships. 
4. Describe how an injury to the brain can result in various behaviors and challenges. 
5. Understand the importance of the motor system in guiding rehabilitation.

Health, Medications and Medical Management

1. Understand the role of the case history in identifying the uniqueness of each individual with a brain injury. Know the strategies for gathering information about the person's background, injury, treatment and factors that impact their potential for optimum recovery.
2. Understand, identify and report signs and symptoms of potential medical and ocular complications that are commonly encountered in persons after a brain injury.
3. Demonstrate knowledge of the most commonly prescribed categories of medications and commonly used drugs after brain injury and their impact on vision.
4. Understand the role nutrition and exercise plays in the healing process.

Understanding Functional Impacts of Brain Injury

1. Describe common cognitive, physical, emotional, behavioral, and social changes after brain injury. 
2. Describe how these changes affect the person's functioning.

Children and Adolescents with Brain Injuries Recognize developmental issues for children and adolescents after brain injury, as well as, neurologic deficits.

Visual Pathways in the Brain

1. Describe the various visual pathways and note their significance. 
2. Understand the significance of the brain stem in the control of eye movements. 
3. Understand how to test the function of the cranial nerves. 
4. Review the various disorders of the cranial nerves involved in vision.

Evaluation of the Oculo-motor System

1. Know how to test the function of extra-ocular muscles. 
2. Understand the different testing procedures for the oculo-motor system. 
3. Understand the integration of the vestibular system, oculo-motor system and somatic feedback. 
4. Review the various disorders of the oculo-motor system.

Specific Visual Deficits Following Brain Injury

1. Understand Post Traumatic Vision Syndrome. 
2. Understand Visual Midline Shift/Egocentric Localization Deficits. 
3. Describe Visual Field Defects. 
4. Describe Unilateral Spatial Inattention. 
5. Understand how to differentiate between Visual Field Deficits and Unilateral Spatial Inattention. 
6. Understand the various visual information processing deficits.

The Examination of the Brain Injured patient

1. Know how to conduct a thorough case history. 
2. Know the goals of the patient and family. 
3. Understand what functions need to be assessed. 
4. Know what tests will be appropriate to administer.

Treatment Protocols for the Brain Injured patient

1. Understand the importance of lenses, prisms and occlusion. 
2. Understand how to set up a treatment plan (in office). 
3. Understand what procedures to use for a specific visual deficit.

Working with the Vision Rehabilitation Team

1. Know the components of a vision screen. 
2. Understand the process of communication with other professionals. 
3. Know how to communicate to the patient and their family. 
4. Understand how to integrate vision rehabilitation into the general rehabilitation treatment plan.
5. Understand the optometrist's role in guiding the vision therapy program. 
6. Understand the optometrist's role in the hospital setting.

The course addresses

1. Working with the Rehabilitation Team
2. The Continuum of Rehabilitative Care
3. Functional Outcomes and Therapeutic Expectations
4. Review of the Twelve Cranial Nerves 
5. The Vestibular System
6. Concepts in Rehabilitation

This is the first such program in this country where background, clinical and scientific knowledge and skills in the diagnosis and treatment of Neuro-Optometric Rehabilitation has been offered. There has been tremendous excitement generated from this new concept of Post-Graduate education.

When your application is received, you will receive detailed information and materials needed to move forward with Fellowship.

For more information about the Clinical Skills courses and/or the Fellowship Program, please contact Derek Tong, OD, FAAO, FCOVD, FNORA: [email protected]


You may also call NORA 949 250-0176