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Behavioral Optometry BOAF Volume1 Number1 2012
Article - Geoffrey A. Heddle, O.D., BSc.
Behavioral Vision (Original English)
Behavioral Vision: What is it?
In traditional Optometry, Optometrists are trained to be able to perform a refraction. The pur- pose of the refraction is to find the lens, or combi- nation of lenses that will compensate for any re- fractive ‘error’ the patient may have. There is an ideal endpoint. The ideal endpoint is usually con- sidered the lens, or combination of lenses that provide the patient with clear sight for looking at a target that is at a distance beyond 20 feet. (Beyond 20 feet is usually considered ‘Optical Infinity’). Of course if the patient is showing presbyopic symp- toms, the Optometrist should do some additional testing to determine the correct ‘add’. This ‘addi- tion’ allows the patient to see near print being held at 16”. (Conventional Optometry is usually only concerned with these two distances, 20 feet and 16 inches.)
During the derivation of this “ideal endpoint”, there is little concern to the amount of spherical, or cylindrical power, or the location of the axis for the cylindrical power in regards to each eye. Perhaps the concept of a Spherical Equivalent (SE) is taught. (The SE power is determined by adding half of the cylindrical power to the spherical power. The SE of a -3.00-1.00x180 prescription would be -3.50. ) The idea would be to have the same SE between the two eyes, but not really much expla- nation as to why this might be important. It was taught that the refraction is a pursuit of the most precise central acuity, or “sharpness”, that the pa- tient can achieve. There seemed to be little regard to the resulting phoric posture that the patient may demonstrate while looking through this prescrip- tion, particularly when it comes to near centered tasks.
Considering the fact that there are not too many Optometry schools teaching the concepts of Behavioral Optometry, it is left to our own intellec- tual curiosity to attend courses, seminars, study groups, etc, as we search for answers to various questions such as, How does the visual system work? What role does vision play in our patient’s lives? What type of demands do our patients put on their visual system? How do these various de- mands affect the visual system? What is the proper development of the visual system? Are our patients meeting their developmental milestones? How do you guid the visual system back to a more ideally functioning state?
Although I have given a bit of a lead in to an answer, I would like to ask a few very simple ques- tions. What does it mean to be “behavioral”? How does one practice Optometry from a behavioral perspective? The main idea for this article is to create thought within the reader as to what they are doing to try and practice Optometry from a
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