Behavioural Optometry

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

BO2 LGSociety 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.

Treating vision

Treating VISION is the goal of Behavioural Optometry. Recent research into neural development has confirmed the validity of many of the strategies promoted by Behavioural Optometry. This research falls under the banner of Neuro Developmental Optometry and is an exciting new area of study.

Optometrists to provide behavioural optometry services use a wide variety of tools and modalities to achieve their goals. These include:

  • Lenses (single vision, bifocals, multifocals, tints, prisms and occlusion (patching)) to modify the sensory input from sight
  • Vision therapy including eye hand, and fine and gross motor activities to develop integration of vision with hand and body movement
  • Vision exercises to encourage an awareness of how information enters the visual system as well as an awareness (and hence control) of the ocular motor systems

There is no one specific mode of practice, although there is commonality in the goals. Some practitioners offer in-office therapy where all the work is done within the professional rooms under the guidance of a therapist, combined with home practice of the exercises to gradually develop vision abilities. Others may use the in-office attendance simply to review findings and provide new activities to be performed at home under the supervision of a carer. Others may simply provide a software program to treat a disorder of VISION, although naturally this is not as complete a treatment has in - office vision therapy.

Why experience matters

The mode of practice typically reflects the knowledge base of the practitioner. Those more experienced tend to provide in-office or guided home therapy. Fellows of ACBO (FACBO) are also more likely to do so, having completed a rigorous program involving private study, open and closed book examinations, clinical research and oral assessment. Fellows are the most experienced and skilled members of ACBO, and are identified by a gold star and highlighted priority listing on the ACBO website member directory.

Different practitioners 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 a unique approach to helping patients with a VISION problem, and may use a variety of treatments. Different practitioners have developed substantial experience in fields ranging from turned eyes to visually -related learning delays to brain injuries, which in turn modifies the clinical models and approaches used.

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


Which patients could benefit from Behavioural Optometry?


All patients can benefit from the more holistic approach, but it is especially suited to those with eye coordination problems, lazy eyes, developmental delays, neurological damage or problems learning to read or reading to learn.

Although the majority of Behavioural Optometrists' patients are children, Behavioural Optometry may be suitable for patients of any age.



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