Eye2Brain Academy


Cerebral Spinal Fluid Leak Case Study


Now 70 year old male tells his story of an injection gone wrong…7 and a 1/2 years ago he went in for a lumbar spine epidural and he ended up with a cerebral spinal fluid leak. This has caused constant, 24/7, headaches that are reported to be all over the head and very severe. 

After being evaluated by Dr. Fitzgerald, OD at Dr. Fitzgerald & Associates, he was referred to complete a Multi-Sensory Reset Therapy (the Vision In Motion Pinnacle Program for those of you that know of it). Throughout the 12 day program, he was dry needled by an Athletic Trainer 2-3 x per week to relieve head pressure and allow the cerebral spinal fluid to flow. The patient states that he felt the largest impact from dry needling than he ever has with any other treatment. 

He continues to receive treatment 1-2x per week during the 1 month period between the end of the MSRT program and his re-assessment with Dr. Fitzgerald, OD. These sessions consist of eye hand coordination exercises, specifically noted benefits from tossing a ball with a partner, and dry needling. 

This patient continues to report improvements in his chronic headaches; that they now occur only at the end of the day. AND that some times he goes days without one at all! Can you imagine going through the trauma that this man has, understanding that he will always be in pain due to the injection gone wrong, and then wake up without headaches multiple days in a row?! That is the power of combining treatments appropriately, utilizing your medicine team, and incorporating a 360 degree health program. 

Cerebral Spinal Fluid Leak Case Study Read More »

Intricate Work Comp Concussion Case

3/9/2023 Concussion Case Study


30 y.o. Female sustains a concussion while holding a child during a co-treat speech therapy session. As the child extended to avoid cueing from another therapist, our patient extended to avoid him and her chair fell back resulting in contact with her head against the wall. 


This patient attempted to continue working without limitations for 2 weeks after being diagnosed with a concussion. Due to severe symptoms of blurred vision, headache, nausea, dizziness, sleep dysfunction, difficulty remembering, difficulty concentrating she was put on workman’s compensation and referred to Dr. Fitzgerald & Associates for concussion rehabilitation. Her baseline post-injury Right Eye Assessment is as follows:


Began with a total symptom score of 32/96 upon beginning concussion rehabilitation. The patient began treatment utilizing the eyes with syntonic light frequency therapy to balance the autonomic nervous system. We were then able to progress to peripheral vision exercises, taking the strain off of her lack of convergence. As her symptoms progressively decreased, she was able to tolerate eye hand coordination exercises, depth perception exercises, and all exercises forcing the eyes to team together with all movements. She was cleared to return to work by her work comp MD for 4 hours per day, multiple days per week. From 1/4/2023 to 1/27/2023 she attempted this schedule, while also doing concussion management around various work hours. This caused stress to her visual and emotional systems due to using her computer to document therapies done with children under duress. 


Due to the consistent symptom score of about 24/96, she began our Multi-Sensory Reset Therapy (Pinnacle Program) for 1 hour per day x 12 days in a row; discontinuing work until further notice. This helped to continue to balance her autonomic nervous system, continue to work toward her eyes working effectively and efficiently together, and decrease her emotional response to stressful situations. She continued concussion management with an Athletic Trainer 3x per week upon completion of this 12-day program. 


Two months after her initial visit, her Right Eye Assessment looks like:

This demonstrates that the patient now needs an increased amount of vestibular integration to reduce symptoms. 


Utilization of compression, weighted lei, and going shoes off to increase proprioception have improved vestibular responses. She also benefited from sound wave therapy, whether it be standing on a vibration plate or utilizing sound waves over both ears. As of 3/8/2023, she arrived at rehabilitation with a total symptom score of 11 and left at a 4/96…! She has improved sleep quality, zero blurry vision, and is able to perform body weight exercises and walking based cardio exercises without symptom provocation. 


She has been back to work for 1 week at 4 hours per day, every morning, with a maximum of 2 patients per day to allow ample documentation time before going home. The patient reports no symptom change or increase with work stimuli now. Below is her Right Eye Assessment from 3/6/2023:

This patient still has some working to do in order to return to her normal, or new normal after concussion. However she has demonstrated significant improvement in every trajectory of concussion.

Intricate Work Comp Concussion Case Read More »

Hockey Puck Case Study

Case Study:
Professional hockey player takes a puck to his right zygomatic arch during a game. He has a clear laceration from the impact. After a trip to the ER for 3 stitches and x-rays, he is clear of any fractures. Dr. Fitzgerald & Associates was able to rule out any retinal damage 2 days after the injury occurred.
At this time the athlete complains of headache pressure around the right eye and zygomatic bone. He was treated with syntonics to balance the autonomic nervous system, the PEMF mat for inflammation, and dry needling around the injury site utilizing homeostatic and symptomatic points. He states that the combination of treatments completely resolved his symptoms of pressure and that he now had mild pressure on the opposite side of his face.
Thanks to this treatment he was able to be cleared of any concussion and play in the games the following week. His Athletic Trainer and equipment manager did make him wear a fishbowl mask around his entire face, attached to his helmet. Due to inter-professional care this athlete, and others, have been able to return to competition so much faster than when working with just one individual.

Hockey Puck Case Study Read More »

Nutrition & Concussion Part 2: Gluten Case Study

Welcome back for part 2 of our Nutrition & Concussion series! This post is a case study on a 13 year old female that sustained a concussion playing basketball. She completed treatment and her return to play protocol, although was still complaining of a 5 minute headache on a daily basis. This headache was not associated with any activity in particular, and in fact went away with physical activity. At this time, with no known cause of the headaches, I had the athlete journal her eating habits for 2 weeks everyday. This included what she ate/drank, when she ate/drank, and when the headache occurred and for how long. We noticed a trend: her headache occurred within 30 minutes after consuming any gluten. I hated to put her on a specific lifestyle change at such a young, influential age, however it was the only thing we had not tried to get rid of her headaches once and for all. The athlete and parent were both more than willing to try going gluten free for 4 weeks to see what happened. Sure enough, the headaches stopped altogether once she substituted her foods with gluten free products. Now, 6 months later, the athlete has completed a gluten re-introduction process and is able to tolerate small amounts of gluten at a time without remorse. She waited until she knew her body was ready (this was a very mindful 13 year old) and listened to her body when it started becoming symptomatic again, by taking out the foods that caused her the headache. With mindfulness and guidance, we can help our athletes reach their goals and change their life long term for the better.

Nutrition & Concussion Part 2: Gluten Case Study Read More »

Updating the Return to Play Timeframe


The above article is associated with World Rugby and their new announcement requiring all athletes that have been diagnosed with a concussion being sidelined for a minimum of 12 days. Formerly this minimum requirement was 7 days across the world, a standard practice regardless of sport. At Dr. Fitzgerald & Associates Vision In Motion clinic, we see numerous athletes, of all ages, that did not think their head impact was “a big deal”. It was only when they began realizing, days later, that they had a headache with certain tasks of daily living, or that they became dizzy when they sat up from lying down, and that they forgot their neighbor’s name across the street. Just like with delayed onset muscle soreness (DOMS) after exercise, symptoms of a concussion can also be delayed. It is important to gain a thorough history of mechanism of injury, symptom provocation, and discuss nutrition, exercise habits, and sleep hygiene when evaluating and treating a concussion. It is equally as important to utilize the return to play protocol appropriately, and monitor the athlete’s heart rate throughout each phase, since symptom provocation may be delayed up to 24 hours, heart rate will tell you immediately if the athlete will have a side effect from any physical or cognitive activity.

Updating the Return to Play Timeframe Read More »

Train Your Brain to See Again!

Happy Friday! 3 weeks until we host our Train Your Brain to See Again Clinic, July 8-9. We will be covering a wide variety of material related to concussion/TBI, stroke recovery, and multi-sensory systems therapy (aka, our Pinnacle Program). This clinic is open to optometrists, physical therapists and assistants, occupational therapists and assistants, athletic trainers, and doctors. If you plan on staying overnight, hotels near us include the Tru Hotel and the Marriott. Both of these have blocks reserved for this clinic, all you have to do is drop the Dr. Fitzgerald & Associates name and request to be put in that block of rooms! The clinic will run from 8-5 with a lunch and learn built in, so be ready to “drink from a firehose” as we call it here at the office. This will also be a great opportunity to build connections with other healthcare providers and build a team of professionals to refer to and work with.

Train Your Brain to See Again! Read More »

When to use Symptom Management vs. Therapeutic Exercise in Concussion Rehab

Symptom provocation after suffering from a concussion/TBI is different among each individual I see. Each day I see someone, I start out with a history of what they have been up to, how much water they’ve been intaking, what they’ve been eating (many times people are not getting enough calories), what their sleep quality is like, and then end the subjective portion of my session with them filling out a symptom survey. This symptom survey is especially important for objective documentation because it gives you, the clinician, and insurance an idea of how the patient is processing their symptom provocation. I do all of this before I even consider what their session will consist of that day. When someone approaches me with significant headache, nausea, or dizziness those are the “Big 3” red flags that tell me this person is not going to benefit from initiating visual, vestibular, or cognitive skills right away; they need symptom management first so their brain and body benefit from the therapeutic exercise. It is not until someone reports to me asymptomatic and with complaints of visual dysfunction, difficulty focusing, memory loss, etc. that I begin a session with therapeutic exercise. This is when it is appropriate to push their brain and body to work effectively together as one system.

When to use Symptom Management vs. Therapeutic Exercise in Concussion Rehab Read More »