✅ Where Vision Meets Vestibular ~ Today’s Price: $8! (regular price $47)
Nearly 200 clinicians registered for this live event! It ended up being one of the most generous clinical conversations we've hosted. Dr. DeAnn Fitzgerald, OD shares her clinical framework for sequencing vestibular rehabilitation, helping you understand how the autonomic, postural, visual, and vestibular systems work together to support patient recovery. Learn why each stage builds on the next, why skipping foundational systems can limit progress, and how applying this hierarchy can help you make more confident clinical decisions and optimize patient outcomes.
Dr. Fitzgerald is a neuro-optometrist in Cedar Rapids, Iowa and former President of the Neuro-Optometric Rehabilitation Association (NORA). 42 years in practice, approximately 10,000 patients a year, and a career built around the intersection of vision, vestibular, autonomic, and concussion rehab.
Throughout the event, she repeated the following clinical hierarchy:
Autonomics → Posture → Spatial Awareness → Ocular Motor → Vestibular Integration → Cognition
Her argument: skip a stage and the next one underperforms. Vestibular therapy fails when ocular motor isn't ready. Ocular motor work fails when the autonomic system is still dysregulated. The recovery is in the sequencing as much as the technique.
📍 Topic Covered:
Assessment & Diagnostic Tools
- Bernell Brewster stereoscope — clinical value and limitations
- Single vs. double Maddox rod — setup, head position, distinguishing fourth nerve palsy from skew deviation
- Verticality iPhone app — SVV assessment validation
Posture, Position & Pre-Existing Findings
- Correcting head tilt before ocular motor testing
- Postural clues as clinical reasoning
- Pre-existing strabismus vs. new post-concussion findings
- Impaired binocular alignment with intact fusion — the decompensation pattern
Micro-Vertical Heterophoria
- The ~90% pattern in concussion patients within the 30–60 day window
Suppression & The Brock String
- When to push for binocular integration vs. work around it
- Strobe-light technique for breaking suppression
- Far-bead suppression and convergence excess
Sequencing & Integration
- Ocular motor sequencing — accommodation, convergence, divergence, pursuits, saccades
- When to integrate vestibular work
- Gaze stabilization as the foundation before pursuits and saccades
Treatment Tools
- Peripheral integration exercises for early concussion rehab
- Tongue exercises and CN 3, 4, 6, 12
- Vibration — hands, feet, and the Z-Vibe ear point
- Dosing, pacing, and recovery time as the metric
Sensory Regulation
- Peripheral awareness collapse — identification and reopening
- Light sensitivity, pupillary response, and the sunglasses trap
- Progressive lenses, aging, and the cervical-vestibular relationship
Specific Conditions
- Post-Traumatic Vision Syndrome
- Visual Snow and the insula
- GLP medications (Ozempic, semaglutide) — AION, cataracts, circulation
- Optic nerve recovery vs. compensation strategy
- Progressive Supranuclear Palsy and prism glasses
The Bigger Picture
- Ocular motor screening beyond concussion — the retina-as-brain reframe
- OT vs. optometric vision therapist — neurovisual rehab as a framework