What is 'Tracking' anyway?
Do Irlen lenses or eye Vision training help?
Why did my child's teacher tell me to try those treatments then?

Behavioural Optometry

It is a field of ‘alternative’ medicine much like reflexology or naturopathy which relies heavily on the placebo effect of ‘treatments’ for possible symptoms when no medically diagnosable condition can be found. The diagnoses given include Irlens syndrome, ‘Poor tracking’, accomodative lag etc. The ‘treatments’ used tend to change depending on what is popular but include colored lenses, reading glasses, bifocal glasses, prism glasses, and various “exercises” or “vision therapies”.

Optometrists are the only ones who practice behavioural optometry techniques even though most children with important eye problems are looked after by doctors and orthoptists. The treatments currently popularised by Optometrists have not been proven to have a sound medical basis, and so are not used by medically trained children’s eye specialists. Optometrists are not doctors, and have very limited training in how to diagnose serious eye problems. Most have only limited university training in treating children’s eye problems apart from the common refractive errors: long-sightedness, astigmatism, and short-sightedness.

However, Optometrists are often asked to see children who are having difficulties with reading or other symptoms that family members or teachers think may be related to eyesight. They may find no medical diagnosis, or the child may have a mild focus error that does not reduce their measured visual acuity in the distance or at near. The most sound way to manage a child in this setting is to reassure the parents and child, and reschedule a follow-up at some stage to make sure they are still doing ok. 

Instead, Optometrists appear to feel some sort of pressure to make a “diagnosis”, and they have developed a battery of tests that are done, and a large number of potential abnormal findings. It often appears quite impressive at the time. Parents want answers and want their child fixed if there is a problem.

Where does all this come from? There is quite a lot of pressure on Optometry practices to offer these services – pressure from each other, and from the need to run a business that makes a profit.

So what’s the problem then? Well, a child who spends months or years wearing glasses that have made no real difference, or having repeated visits for treatment has not been managed well, and the families have suffered at least economically. It is even worse if a real diagnosis such as Dyslexia is delayed, or the treatment impacted by having spent many hundreds of $ on unhelpful vision therapy or glasses.