The author is a GOC-registered Optometrist but is not a member of the College of Optometrists or of BABO (see Appendix).
A critical evaluation of the evidence supporting the practice of behavioural vision therapy
Article first published online: 22 DEC 2008
© 2009 The Author. Journal compilation © 2009 The College of Optometrists
Ophthalmic and Physiological Optics
Volume 29, Issue 1, pages 4–25, January 2009
How to Cite
Barrett, B. T. (2009), A critical evaluation of the evidence supporting the practice of behavioural vision therapy. Ophthalmic and Physiological Optics, 29: 4–25. doi: 10.1111/j.1475-1313.2008.00607.x
- Issue published online: 22 DEC 2008
- Article first published online: 22 DEC 2008
- Received: 28 July 2008 Revised form: 2 September 2008 Accepted: 10 September 2008
- alternative/complementary therapies;
- behavioural optometry;
- vision training;
- visual therapy
In 2000, the UK’s College of Optometrists commissioned a report to critically evaluate the theory and practice of behavioural optometry. The report which followed Jennings (2000; Behavioural optometry – a critical review. Optom. Pract. 1: 67) concluded that there was a lack of controlled clinical trials to support behavioural management strategies. The purpose of this report was to evaluate the evidence in support of behavioural approaches as it stands in 2008. The available evidence was reviewed under 10 headings, selected because they represent patient groups/conditions that behavioural optometrists are treating, or because they represent approaches to treatment that have been advocated in the behavioural literature. The headings selected were: (1) vision therapy for accommodation/vergence disorders; (2) the underachieving child; (3) prisms for near binocular disorders and for producing postural change; (4) near point stress and low-plus prescriptions; (5) use of low-plus lenses at near to slow the progression of myopia; (6) therapy to reduce myopia; (7) behavioural approaches to the treatment of strabismus and amblyopia; (8) training central and peripheral awareness and syntonics; (9) sports vision therapy; (10) neurological disorders and neuro-rehabilitation after trauma/stroke. There is a continued paucity of controlled trials in the literature to support behavioural optometry approaches. Although there are areas where the available evidence is consistent with claims made by behavioural optometrists (most notably in relation to the treatment of convergence insufficiency, the use of yoked prisms in neurological patients, and in vision rehabilitation after brain disease/injury), a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated.