Behavioural optometry is a specialised branch of optometry that deals with many different aspects of vision, including visual development, visual perception, strabismus, amblyopia, vision therapy and specialised visual aids.
Behavioural optometrists have done an undergraduate Optometry degree and then a further year of postgraduate study in Behavioural Optometry. Continuing education is undertaken regularly to keep knowledge up to date with the latest research findings. For further information see the Australasian College of Behavioural Optometrists (ACBO) website: www.acbo.org.au
Behavioural optometrists have additional training in the management of a range of eye conditions that commence in childhood such as strabismus (eye turn), and amblyopia (lazy eye). Children who are struggling at school may benefit from an assessment by a behavioural optometrist, as part of a multiple-disciplinary approach to finding out the cause of their learning difficulties. Children with developmental issues including low birth weight, prematurity, physical disability or brain injury can also benefit from a behavioural optometry assessment to find out whether their skills are up to age-expected levels. This information can be particularly helpful when making the decision as to when to start the child at school.
Behavioural optometrists can assess the child’s visual perceptual skills, and the accuracy and efficiency of pursuit and reading eye movements. Visual perceptual assessment includes the assessment of:
Behavioural optometrists not only diagnose problems with visual perception and eye movement control, but can also provide vision therapy to improve on these skills.
Initially a general eye examination is performed that will detect if there is a requirement for any visual aids, such as glasses or contact lenses. Glasses may be required to correct blurred vision caused by myopia, hyperopia or astigmatism, or to correct a problem with poor binocular co-ordination (e.g. convergence excess), or poor accommodation (poor focus at near).
Sometimes learning issues are detected, either through the history taken at the initial examination or from our parent questionnaire, which indicate that further assessment would be beneficial to determine whether visual perception is the cause of the learning difficulty. In this situation the child would be booked in for an hour appointment for a visual perceptual assessment.
This appointment is usually scheduled in the morning when the child is fresh, and usually the parent is asked to wait in the waiting room. This is to ensure that the child is not distracted, and can answer the questions asked of them at their own level or ability. Each visual perceptual test has an age appropriate range – most stop around age 13 - with a few exceptions. For this reason the most comprehensive assessments can be done for children of primary school age rather than those at secondary school.
After the visual perceptual assessment, a comprehensive report is written detailing the child’s visual perceptual skills, diagnosis and recommendations. Possible recommendations include vision therapy (prescribed activities aimed at training the reduced visual perceptual or eye movement skills), or referral to another professional. Sometimes we might refer to an educational psychologist (for a comprehensive assessment of the child’s learning skills), an audiologist or a speech therapist (if there seem to be problems with hearing or following directions), or an occupational therapist (if the visual-motor integration is poor). If no particular defects of vision or visual perception are found, a routine eye examination is recommended as indicated.