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Vision therapy. Information for health care and other allied professionals. A Joint Organizational Policy Statement of the American Academy of Optometry and the American Optometric Association.

Vision therapy is prescribed to treat diagnosed conditions of the visual system. Effective therapy requires visual skills to be developed until they are integrated with other systems and become automatic, enabling individuals to achieve their full potential. The goals of a prescribed vision therapy treatment regimen are to achieve desired visual outcomes, alleviate the signs and symptoms, meet the patient's needs, and improve the patient's quality of life.

Humans↗

Citation patterns in the optometric and ophthalmologic clinical binocular vision literature.

PURPOSE: The purpose of this study is to compare citation patterns in the clinical binocular vision literature of optometry and ophthalmology. METHODS: The author conducted citation analysis of two current clinical binocular vision textbooks from optometry and two from ophthalmology and of articles published in the years 2000 to 2004 in optometry and ophthalmology journals. Topical parameters for inclusion of sources were diagnosis and management of nonstrabismic binocular vision disorders, diagnosis and management of nonpresbyopic ocular accommodation disorders, and procedures for examining such conditions. These topical parameters were chosen because they are areas in which the diagnostic procedures and treatment options available to members of the two professions are not delineated by their respective scopes of practice. RESULTS: The most frequently cited journals in the optometric publications were optometry journals (63% of citations in the optometry textbooks and 58% in the optometry journal articles). The most frequently cited journals in the ophthalmology publications were ophthalmology journals (79% of citations in the ophthalmology textbooks and 49% in the ophthalmology journal articles). Each discipline also cited a greater variety of journals from within its own field than was cited by the other discipline. The journal with the highest total number of citations was Optometry and Vision Science (280) followed by Ophthalmic and Physiological Optics (73), American Journal of Ophthalmology (68), Investigative Ophthalmology and Visual Science (62), and Optometry (61). CONCLUSIONS: Optometry and ophthalmology sources show more citations to materials from their own discipline than from their fellow discipline in the area of nonstrabismic binocular vision disorders and nonpresbyopic accommodative disorders. Reasons may include lack of awareness of the literature of the other discipline, bias toward the literature of one's own discipline, or bias against the literature of another discipline. It is also likely that the diagnostic and management strategies of the two professions are significantly different, although scope of practice would not constrain the range of strategies for the conditions chosen as the topical matter for consideration in this study. The journals found to be most frequently cited in this study should help to identify the core journals in this area of clinical binocular vision.

Adolescent↗

Report on the status of vision care in Israel.

Recognition of optometry in Israel has not been achieved due to various factors: the lack of recognition by the Ministry of Health in proposing a law of optometry to the Knesset (Parliament); the opposition of organized ophthalmology; the internal conflict between the various associations of opticians and optometrists within the country which lead to a lack of unification for propagation of a law of optometry; the absence of an academic institution of learning in optometry. The establishment of the Optometric Centre by the American Friends of Israel Optometry has instituted low vision clinics and post-graduate courses which have helped to advance optometry. Optometry must become organized in order to apply pressure on the Ministry of Health in order to recognize optometry as an independent profession. There is a need for the establishment of operating courses to equalize the standard of eye-care in the profession, and for the founding of an academic school of optometry to maintain a constant supply of qualified optometrists.

Humans↗

Assessing the predictive ability of the test-positive findings of an elementary school vision screening.

PURPOSE: The purpose of this study is to assess the predictive ability of the test-positive findings of an elementary school vision screening program, conducted by 2nd-year optometry students, in identifying children with eye or vision disorders. METHODS: A modified version of the Modified Clinical Technique (MCT) vision screening was administered to elementary children from a below-average socioeconomic neighborhood in Houston, Texas. Comprehensive eye and vision examinations were provided to the available children who failed the vision screening. The screening was administered by groups of 2nd-year optometry students with the assistance of a 4th-year optometry student, and supervised by a faculty member licensed to practice optometry. The follow-up examinations were provided by supervised 4th-year optometry students in a clinical setting based at the elementary school. Positive predictive values calculated from the screening and examination findings estimate the probability that a failure on one or more of the screening tests would identify children with eye or vision disorders. RESULTS: Sixty-nine percent of the test-positive children examined were found to be true positives by the criteria developed in a study of vision screening methods in Orinda, California from 1954 through 1956. CONCLUSIONS: The predictive ability of this study's test-positive findings for identifying eye and vision disorders was found to be less than the predictive ability of the Orinda Study findings. This reduced predictive ability of the present study resulted in a larger number of children being overreferred for examinations than had occurred in the Orinda Study. The reduction in the ability of the test-positive findings of the current study's screening program to identify accurately children with eye and vision problems is most likely due to the limited experience of the optometry students conducting the screening program. The inability of this retrospective study to evaluate the accuracy of the test-negatives is a major limitation in assessing the total effectiveness of this vision screening program. Although the present study may indicate some value in optometry students conducting elementary vision screening programs, a prospective study which could assess the predictive ability of both test-positive and test-negative findings, as well as determine the sensitivity and specificity of the screening program, is needed to assess more fully the effectiveness of school vision screening programs using professional students.

Adolescent↗

Use of the experience sampling method to measure nearwork.

PURPOSE: The purpose of this study was to use the Experience Sampling Method (ESM) to evaluate the daily visual activities of a group of optometry students and to determine whether the ESM could detect differences in visual activities when a difference was thought to exist. METHODS: Sixty-two optometry students, at four different levels of training, at The Ohio State University College of Optometry were tested using the ESM during a 14-day period. A subgroup of 18 subjects in their fourth year of study was asked to repeat the 14-day ESM on a second occasion. The two ESM periods were specifically chosen at times when the subjects were expected to have markedly different nearwork profiles. RESULTS: A comparison of members from the four optometry classes when the fourth-year students were taking final written examinations showed no significant differences in the proportion of nearwork among groups (p = 0.170); however, when the fourth-year students were primarily performing eye examinations during clinical rotations, there was a significant difference in the proportion of nearwork among training levels (13.8% for fourth-year students compared with 24.9%, 23.7%, and 30.4% for the other optometry classes; p = 0.0001). The percentage of time spent doing nearwork and performing eye examinations was significantly different between two ESM periods (paired t-test, p = 0.0001 for each activity). CONCLUSIONS: The ESM is capable of detecting differences in the proportion of time spent doing nearwork and performing eye examinations among groups of optometry students in different levels of training with different daily visual demands and between two ESM periods when these activities were expected to differ. The ESM can be used as an alternative method for nearwork quantification in future studies.

Adult↗

What healthcare students do with what they don't know: the socializing power of 'uncertainty' in the case presentation.

Healthcare students learn to manage clinical uncertainty amid the tensions that emerge between clinical omniscience and the 'truth for now' realities of the knowledge explosion in healthcare. The case presentation provides a portal to viewing the practitioner's ability to manage uncertainty. We examined the communicative features of uncertainty in 31 novice optometry case presentations and considered how these features contributed to the development of professional identity in optometry students. We also reflected on how these features compared with our earlier study of medical students' case presentations. Optometry students, like their counterparts in medicine, displayed a novice rhetoric of uncertainty that focused on personal deficits in knowledge. While optometry and medical students shared aspects of this rhetoric (seeking guidance and deflecting criticism), optometry students displayed instances of owning limits while medical students displayed instances of proving competence. We found that the nature of this novice rhetoric was shaped by professional identity (a tendency to assume an attitude of moral authority or defer to a higher authority) and the clinical setting (inpatient versus outpatient settings). More explicit discussions regarding uncertainty may help the novice unlock the code of contextual forces that cue the savvy member of the community to sanctioned discursive strategies.

Clinical Competence↗

The evolution of optometric education in America.

BACKGROUND: The first American optometry law was passed in Minnesota 100 years ago. That law--and the others that followed--determined the minimal educational requirements to practice optometry. Legislating the practice of optometry was the first step in changing optometric education, from a short course in refraction to an accredited university program. As the practice of optometry has changed and evolved over the past 100 years, so has the optometry school education. PURPOSE: This article chronicles the changes that have occurred in optometric education during this evolutionary period.

Curriculum↗