What is behavioural optometry? [Glossary]

Your visual system brings you much information about your world. When you look at something, you don't just 'see' with your eyes you inspect, discriminate, identify and interpret all as part of your visual system. Behavioural vision care is an expanded area of optometric practice. Eyesight is the ability to see something clearly. Vision goes beyond eyesight and is the understanding of what is seen. Vision involves the ability to take incoming visual information, process that information and obtain meaning from it.

At my practice, I am finding that a lot of my patients are having difficulties with their convergence.The problem is exacerbated as both in schools and workplace, due to the use of computers, the amount of close work for prolonged periods of time has increased. Added to this is that more time is again spent on the computer, iPad, iPhone or smartphone, for leisure. Our bodies are meant for moving and not designed for this amount of extended close work. Many children do not realise that double vision is a problem and think it is normal until it is brought to their attention that it is NOT!

Convergence Insufficiency is a common eye teaming problem in which the eyes do not work at near easily. The eyes have a strong tendency to drift outward when reading or doing close work. If the eyes do drift out, then double vision is likely. To prevent double vision, one has to exert extra effort to make the eyes turn back in (converge). This extra effort can lead to a number of frustrating symptoms which interfere with one's ability to read and work comfortably at near.

Frequent breaks should be encouraged using the 20/20/20 rule as a guideline. For every 20 minutes of near work, take a 20 second break, and move around and look 20 feet away (looking out of the window), thereby relaxing the accommodative (focusing) system.

The optometric vision enhancement training will improves visual comfort, ease and efficiency at near. It is designed to increase visual awareness, visual efficiency and visual processing. Scientific research by the National Eye Institute has proven that practice-based combined with home based optometric vision therapy is the most successful treatment for convergence insufficiency (see references 1 and 2 below).

1. Convergence Insufficiency Treatment Trial Study Group. Randomized clinical trial of treatment for symptoms of convergence insufficiency in children. Archives of Ophthalmology. 2008 Oct;126 (10):1336-49.

2. Efficacy of treatment for convergence insufficiency using vision therapy. Paul Adler, Ophthalmic physiologic optics the journal of the British College of Ophthalmic Opticians, November 2002, volume 22 issue 6 pages 556-571

Do you have a vision problem? (link)

20/20 or 6/6 eyesight is measured in a standard eye examination with a Snellen eye chart and means that a child is capable of seeing clearly at a distance of twenty feet or six metres. Unfortunately, how well a child sees at twenty feet (or six metres) has little to do with how their vision functions at the reading and learning distance - approximately 30cm to 40cm from the face. In fact, the Snellen eye chart test which measures eyesight actually does more harm than good. It gives both parents and teachers a false sense of security that vision is normal. There are many other important visual skills that might not be developed even though eye sight at distance is normal.

Behavioural Optometry is an approach to vision care to develop these visual skills which provide for an efficient visual system.

Who needs a behavioural optometrist?  

Behavioural Optometric care can be used to help virtually anyone. However the following individuals will benefit:
- Children of all ages, but especially children just starting school
- Children who are having trouble with reading or learning, or who are reading ‘below their potential’
- Children who seem to be uncoordinated on visually demanding sports
- Children diagnosed as ADD/ADHD
- Anyone who participates in sports and wants improved performance
- Anyone who works at a computer
- Anyone who has a visually demanding job
- Anyone who suffers from motion sickness (sea-sickness)
- Anyone who suffers from burning, itchy eyes, eye strain or visual fatigue

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