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Evidence Based Medicine

You will no doubt hear from time to time that Behavioural Optometry is not evidence based medicine.

The facts are that is it simply not true. There is extensive evidence for the scientific basis of our testing and treatment methods in the areas of vision function and visual perceptual development. Some of the links will be seen below and others can be found on the Australian College of Behavioural Optometrists website.

So why do some groups continue to claim there is no evidence? Unfortunately many of these groups have old and unscientific opinions that say vision is not important for learning. This is obviously untrue and our optometrists are well aware of the latest research which supports the assessment and remediation of visual difficulties.

In order to support our community and our clients, our optometrists will share short summaries of journal articles to allow our evidence base to become evident for all to see.

Visually Related Learning Difficulties:

Association between fine motor skills and binocular visual function in children with reading difficulties. Niechwiej-Szwedo EAlramis FChristian LW.   2017 Dec;56(Pt B):1-10.

In this article, a strong link is found between accommodative facility (a focusing flexibility test) and students with fine motor and reading difficulties. The fine motor difficulties were only encountered when there was a binocular vision component to the task.  The recommendations based on the results were that all children with reading problems should undergo a comprehensive examination that includes a binocular vision examination.

Vision Therapy

The article below reviews the importance of addressing specific aspects of vision therapy for successful outcomes. For vision therapy to be effective, it must reflect an understanding of the visual process to be more than a mechanical neuromuscular ability. It then highlights why virtual reality systems are so effective in amblyopia (lazy eye) and strabismus (turned eye) This is because in virtual reality, the amblyopic visual system is forced to use both eyes together to successfully complete the task. The article also introduces the idea that virtual reality can be used for rehabilitation in people with traumatic brain injury.

Vision Therapy and Virtual Reality Applications

Fortenbacher DL, Bartolini AB, Dornbos B.  Advances in Ophthalmology and Optometry. 2018; 3(1): 39-59.

Visually Related Learning Difficulties

Impact of Simulated Hyperopia on Academic-Related Performance in Children
Narayanasamy S et al. Optom Vis Sci 2015;92:227–36.

This article describes how a relatively low level of simulated bilateral hyperopia (longsightedness) (2.5D) impaired children’s performance on a range of academic related outcome measures, with sustained near work further exacerbating this effect.

Ametropia, Preschoolers’ Cognitive Abilities, and Effects of Spectacle Correction

Roch-Levecq A et al. Arch Ophthalmol. 2008;126(2):252-258.

This small study found that preschoolers with ametropia (abnormal refractive conditions) scored poorly on tests for visual-motor integration however after wearing glasses for 6 weeks their score improved to normal levels. This suggests that early identification and correction should optimize cognitive development and learning.

Vision screening outcomes of Grade 3 children in Australia: Differences in academic achievement

White, Sonia L.J., Wood, Joanne M., Black, Alex A., & Hopkins, Shelley. International Journal of Educational Research, 2017 83, pp. 154-159.2017

This study found that 33 out of 109 Grade 3 children were borderline/unsatisfactory by a vision screening.   The children that were referred for a full exam also scored significantly lower on literacy and numeracy tests (NAPLAN) when compared to their peers who passed the vision screening. This highlights the importance of early vision screening to identify children achieving below their learning potential ensure optimal vision for learning.