Behavioral optometry: a historical perspective.

Abstract

BACKGROUND: The term behavioral optometry is often used to refer to all aspects of practice associated with case analysis and vision therapy. Practitioners with differing backgrounds and perspectives may use the term differently, resulting in poor communication. METHODS: The evolution of behavioral optometry is reviewed from a historical perspective, to identify the various lines along which the field has developed and to clarify the differing perspectives that result. RESULTS: Behavioral optometry had its origins in strabismus orthoptics and in case analysis systems developed to resolve asthenopic complaints in nonstrabismic individuals. From these roots, behavioral optometry has evolved along two complementary lines. Traditional, physiologically-based models emphasize accommodation-convergence relationships and the mechanisms of vergence dysfunction. Behavioral approaches emphasize the influence of environment and experience upon visual function, the relationship of vision to other aspects of organismic behavior, and the role of vision as a modality for gathering and processing information. CONCLUSIONS: The past 50 years has brought substantial growth in the scope of behavioral optometric care, with consideration of the role of vision in relation to school achievement, VDT use, sports, spatial and motor organization, and information-processing. Models of care emphasize prevention, remediation, rehabilitation, and enhancement. Behavioral optometry is an integral component of optometric education and practice.