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Posted on 08-15-2013
Previously on Dr. Gallop’s Blog…
What is preventive visual care?
The basic concept is simple. The visual process develops at an acceptable pace and to an acceptable degree for some people, but now for everyone. There are certain levels of ability that are expected to be present as far as eye movements, eye teaming and focusing. Behavioral optometrists have developed a very good idea of the expected level of visual ability for people of various age ranges. The rest of the medical community, and this includes the majority of general optometrists, has little familiarity with and no interest in visual development and no real interest in the nuances of the visual process or how all of this might impact the lives of people. The general medical community certainly has little if any interest in the concept or preventive visual care.
Preventive Visual Care, Part 2
Preventive visual care is an unfamiliar issue for the general public and eye care professionals alike. Dentistry faced a similar problem many years ago. It used to be that a visit to the dentist only followed tooth pain. It took quite a while, but the dental profession finally figured out that an ounce of prevention was worth a ton of cure. I think they always knew this, but never gave it the prominence it deserved. I believe this decision changed the face of dentistry for both doctor and patient. Now preventive dental care is standard operating procedure for the most part.
I have been advocating for a similar transformation in optometry. One difference is I don’t think many optometrists have the slightest notion of what preventive care might look like in the context of the visual process. Optometry has the knowledge base and ability to change the general perception of what visual care is all about. Unfortunately, most doctors are not particularly interested broadening their horizons in this direction yet. It seems so easy to just keep doing the same old thing and not rock the boat, especially since the general public has no idea there is another way. I have published articles that attempted to encourage my colleagues to consider a more preventive outlook…to little effect. So now, with my very own blog in hand, I will do what I can to stimulate change from the ground up. I have no doubt that if more people requested preventive care there would be more than enough practitioners willing to provide it.
There is another major issue when considering the importance of preventive vision care. Humans are not biologically designed for long periods of reading and looking at computers. We are even less equipped for doing this hour after hour, day after day, year after year. Obviously we are able to do these things with varying degrees of success and varying degrees of stress. The latest addition of texting, touch pads, hand-held gaming and watching movies on smart phones and other smallish hand-held devices will likely cause even more visual problems for more people for some time to come. I recently saw a little boy, who looked to be about six, with a phone propped up between him and his plate of chicken tenders and fries – there’s nothing healthy about this picture – reaching for his plate without ever looking away from the tiny screen. Our visual systems evolved for action and for carrying out three-dimensional tasks. The long periods of time we spend sitting and looking at flat surfaces are stressful for our bodies and our visual systems.
Many people manage to succeed in our visually demanding culture, but many others either do not succeed or do so at some expense to their visual comfort. Nearsightedness (myopia) is probably the most common side-effect of inefficient near tasks. We adapt our visual systems to meet the needs in our daily lives – to get good grades, to keep or improve our position at work, to defeat our best friend on the tennis court. Often, these adaptations help us achieve in specific circumstances while negatively affecting our overall performance and comfort. The motivated are likely to succeed no matter what; the less motivated are likely to see their life’s options limited by the restrictions on performance created by poor visual skills.
One problem with visual discomfort is that it is usually less than obvious for a considerable period of time – sometimes for decades. Some people seem to suddenly develop symptoms such as headaches, neck strain, fatigue, loss of distance acuity, double vision, dry eyes, etc. These symptoms can appear at almost any age. In most cases the causes of these symptoms have been brewing for a long time. The negative impact can be subtle and most people are completely unaware of the damage being done until it reaches the boiling point and obvious symptoms emerge. Obviously this is past the point of prevention and now it’s clean-up time.
Behavioral optometrists understand better than any other professionals how the visual process develops and functions. Behavioral optometry is based on the principle that the primary purpose of the visual process is to direct action. We also understand that the visual process develops throughout our lives and that the visual system can be protected and enhanced through proper care.
It is always better to prevent a problem than it is to try to fix something once it is broken. It’s never too early for a child or infant to have a developmental visual evaluation. And it’s never too late to prevent things from getting worse or to enhance visual performance. Behavioral optometrists are currently the only professionals with the expertise necessary to provide developmentally oriented and performance based preventive visual care.
Next time: Doc, Do I Really Have To See That Clearly?
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