Behavioural Optometry involves an understanding of VISION and how it is different from EYESIGHT. EYESIGHT simply involves seeing an eyechart on the wall, while Behavioural Optometry is more interested in VISION.
Vision includes sharpness of sight at distance and near; ability to aim and focus the eyes properly especially for near vision tasks such as reading and computers; the ability to sustain focus for long periods of time for reading and computers; tracking the eye movements for reading fluency and accuracy; processing of the visual information each the eyes take in; and of course health of the eyes inside and out.
All patients can benefit from the more holistic approach, but it is especially suited to those with eye motor control problems, lazy eyes, developmental delays, acquired brain injuries concussion, or delays in learning to read, or problems reading to learn.
Although the majority of Behavioural Optometrists' patients are children, Behavioural Optometry may be suitable for patients of any age.
EYESIGHT essentially refers to the physical attributes and performance of the many organic components involved in the visual system. Thus there is a high emphasis on structure, pathology and measurements of function of these components.
20/20 vision is a commonly quoted measure of normal sight, yet it simply describes the sensitivity of the eye to see fine detail in the distance. This is certainly an important measurement but having 20/20 vision does not guarantee that a person can read. Reading requires good VISION.
In most instances VISION uses sight as its foundation. So understanding all aspects of traditional optometry is extremely important to a Behavioural Optometrist. VISION involves all of the functions of focusing and aiming and moving the eyes, together with information from many sensory systems such as control of movement and balance to to complete everyday tasks such as walking, reading and driving.
All this is in turn processed, linked to memory, and an image of the world or object is created. This overlay of the senses is evident in the Thalamus, a key component of the brain, which regulates which sensory modality is being accessed at any point.
VISION is learned, so understanding the normal developmental pathway of an infant, from child to teenager to adult is extremely important to Behavioural Optometry. A child with limited environmental experiences, such as reduced physical play and exploration of the world, is more likely to show abnormal development of VISION. Likewise a child with deficiencies in the physical structures that provide the initial sensory information, such as a child with significant long sightedness or a lazy eye or turned eye, is also more likely to show abnormal development of VISION.
A child with a VISION problem may experience difficulty learning to read and write that is not necessarily related to intelligence. One of the goals of Behavioural Optometry is assessment of development of visual abilities and processing, and possible vision therapy to develop these skills to age-appropriate levels, so the child can achieve to their potential.
Many adults who once had normal VISION may experience vision problems, such as blurred or double vision, after sustaining head injuries, strokes, car accidents and neurological disease (such as Multiple Sclerosis) as brain function is often impacted. Behavioural Optometrists with substantial experience in this area can provide comprehensive assessment of vision and brain function after acquired brain injury thus providing opportunities to help activities of daily living and improvement in quality of life.
Vision is Motor
Society has become increasingly complex, requiring that VISION be used to complete tasks for which it was not designed, such as prolonged computer use. VISION develops from physical use as a baby to reach and touch things, building a sense of the visual-spatial world through reaching and walking and holding things. VISION creates a three dimensional reality that can be used to plan motor activities to allow physical interaction within the environment in order to survive.
Crossing a road uses VISION. Looking ahead and then to the left and right provides information about the distances of the key objects involved in the task. The mind then calculates if the body has enough time to take enough steps to cross the road before being hit by a car. Good VISION is essential to survival!
VISION is learned, which is why parents hold the hand of a child crossing a road. This is one of the key reasons why Behavioural Optometry may integrate eye hand and body movement activities within training programs for young children who are still developing their visual motor abilities to play sport and read. It is also why simple computer only programs are not as effective in treating VISION problems.
Goals of Behavioural Optometry
The goals of Behavioural Optometric care are:
- To reduce development of VISION problems and eye problems
- To provide remediation or rehabilitation for VISION or eye problems that have already developed (e.g. eye turn, short-sightedness, visual sequelae of brain trauma etc)
- To develop and optimise the visual skills needed to achieve more effective visual performance in the classroom, work place, when playing sport and following recreational pursuits
Why professional development is important
ACBO is an organisation that provides extensive learning opportunities to its Member optometrists who are committed to professional development, and to exploring knowledge about human vision.
Fellows of ACBO (FACBO) have demonstrated high levels of interest and motivation, having completed a rigorous program involving private study, open and closed book examinations, clinical research and oral assessment.
Different ACBO optometrists may describe their services in different ways. Optometrists assessing the vision function and development of visual processing of children with reading issues may call the assessment anything from a “visual perception examination” to “visual information processing assessment. Each Behavioural Optometrist brings their education and experience to helping patients with a VISION problem, and may recommend a variety of treatments.
Each practitioner has developed substantial experience in fields ranging from turned and lazy eyes to learning related vision problems, and issues of vision function possibly caused by brain injuries or stroke. The tests and treatment used will depend on the particular concerns and vision problems found.
Can I benefit from Behavioural Optometry?
If you are concerned about your vision or the vision of your child or relative, ACBO recommends that you make a time to visit and ACBO Member optometrist, or other appropriate health professional.
Optometrists who offer behavioural optometry services provide comprehensive assessment of vision and eye health, and if indicated more intensive testing of complex vision problems.
When you have had your vision checked, and all the relevant factors have been considered, a plan for managing any identified issues can be made. Your optometrist will advise you about the problems and possible solutions specifically for your situation.