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David Shanahan Blog

News and updates from the world of optometry and opthalmology

Behavioural Optometry

Behavioural Optometry is many things to many people even within the profession. The common link is the understanding of vision and how to encourage its development. Defining Behavioural Optometry involves understanding how vision differs from eyesight. Traditional optometry is more concerned with eyesight whilst Behavioural Optometry is more interested in vision. It tends to be more holistic in its approach as it tries to incorporate the physical, neurological and developmental aspects of vision. It is especially suited to those with eye motor control problems, lazy eyes, developmental delays, neurological damage or learning delays.

More specifically vision refers to sharpness of sight at distance and near; the ability to aim and focus the eyes properly especially for near vision tasks such as reading and computers; tracking the eye movements for reading fluency and accuracy; measuring the visual information each the eyes take in and of course health of the eyes both inside and out.

Although traditionally the majority of Behavioural Optometrists' patients have been children, Behavioural Optometry may be suitable for patients of any age if their condition is likely to respond to this treatment. 


In most instances vision uses eyesight as its foundation. So understanding all aspects of traditional optometry is extremely important to a Behavioural Optometrist. Unlike eyesight, which is strongly related to the performance of components in the visual pathway, vision is a thought process. Vision combines information from many sensory systems to create a perception of reality.
Vision uses information from all the senses, including hearing, smell, touch and even the taste!  All this is in turn processed, linked to memory, and an image of the world or object is created. 

Vision is learned, so understanding the normal developmental pathway of an infant, through to child to teenager to adult is extremely important to Behavioural Optometry. Basic vision is learned at a young age through experience and motor interaction within the environment. A child with limited environmental experiences is more likely to show abnormal vision. Likewise a child with deficiencies in the physical structures that provide the initial sensory information is also more likely to show abnormal development of vision.

A child with a vision problem may experience a learning delay that is not necessarily related to intelligence. Intervening to provide the stimulation required to encourage more normal development of vision is one of the primary goals of Behavioural Optometry.

Many adults who once had normal vision may experience a change after sustaining head injuries, strokes, car accidents or neurological disease (such as Multiple Sclerosis) as brain function is often impacted. Behavioural Optometry aims to understand the role of brain function in vision, thus providing opportunities to help these people.

Vision is Life

Society has become increasingly complex meaning our vision is used to complete tasks for which it was not designed. Vision creates a three dimensional reality that the brain uses to to plan movement and to allow physical interaction within the environment in order to survive.
Crossing a road uses vision. Looking ahead and then to the left and right provides information to our brains on the distances of the objects. Ten our brain calculates if the body has enough time to take enough steps to cross the road before being hit by a car. Good vision is essential to our survival!

Abnormal vision can be improved by providing an environment that triggers key developmental processes in an appropriate order. This is one of the key reasons why Behavioural Optometry integrates body movement activities within training programs. It is also why simple computer only programs are not as effective in treating vision problems.

Treating vision

Behavioural Optometrists use a wide variety of tools and therapeutic methods to achieve their goals. These include:

  • Lenses (single vision, bifocals, multifocals, tints, prisms and occlusive) to modify the sensory input 
  • Gross motor activities to assist with integration of body knowledge with other senses
  • Eye exercises with specific goals to encourage an awareness of how information enters the visual system as well as an awareness (and hence control) of the ocular motor systems

There are even more specific therapies such as syntonics, colorimetry and neuro feedback programs which some more experienced Behavioural Optometrists may adopt, depending on the patient profiles and goals in therapy.

Goals of Behavioural Optometry

The goals of Behavioural Optometry are:

  • To prevent vision and eye problems from developing
  • To provide remediation or rehabilitation for vision or eye problems that have already developed 
  • To develop and enhance the visual skills needed to achieve more effective visual performance in the classroom, work place, when playing sport and following recreational pursuits

Who could benefit from Behavioural Optometry?

Most patients can benefit from the more holistic approach to health care but it is especially suited to those with eye/motor control problems, lazy eyes, developmental delays, neurological damage or learning delays. Although the majority of Behavioural Optometrists' patients are children, Behavioural Optometry may be suitable for patients of any age if their condition is likely to respond to this treatment.

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