An optometrist generally serves as a primary healthcare provider for the eyes, focusing on diagnosing, treating, and managing diseases and disorders of the visual system, and determining the need for corrective lenses. A developmental optometrist, however, is a specialist who focuses on how vision functions and is processed by the brain, rather than simply the clarity of sight. This specialization, often called behavioral or functional optometry, is concerned with how an individual’s visual skills influence their behavior and their ability to perform daily tasks, such as reading and learning. They operate on the understanding that seeing 20/20 is only one component of the entire visual process.
Defining the Developmental Optometrist Specialization
Developmental optometry is built upon the philosophy that vision is a learned skill that develops over time. This field views vision as an integrated process, where the eyes and brain work together to receive, process, and understand visual information. Specialists in this area undergo post-doctoral training, which can include two to three years of residency programs focusing on vision therapy and rehabilitation.
These optometrists assess the entire visual system, looking beyond basic visual acuity to evaluate skills needed for tasks like reading and sustained concentration. They study how the visual system integrates with motor skills and perception. Many developmental optometrists pursue board certification through organizations like the College of Optometrists in Vision Development (COVD), which requires rigorous clinical experience and examinations. This additional training allows them to address functional vision problems that can significantly impair a person’s ability to learn or maintain attention.
Differences in Scope and Examination
A routine eye examination primarily evaluates visual acuity, eye health, and refraction to determine the appropriate prescription for glasses or contact lenses. While this type of exam is important for detecting disease and correcting distance vision, it often does not detect underlying functional vision issues. A developmental vision evaluation, by contrast, is a comprehensive assessment that delves into over a dozen visual skills necessary for academic success and comfortable vision.
The developmental optometrist uses specialized tests to assess how the eyes work together, a process known as binocular vision. They measure visual processing speed, eye teaming, and the eyes’ ability to maintain clear focus at various distances for extended periods. These specialists look for issues with eye movement skills, such as tracking smoothly across a page, and eye teaming, which is the ability of the eyes to align accurately.
Functional Vision Issues They Treat
Developmental optometrists treat a range of problems that interfere with the efficient use of vision, often manifesting as difficulties with reading or near-point tasks. One common condition is convergence insufficiency, where the eyes struggle to turn inward to aim accurately at close objects, which can cause eye strain, double vision, and headaches. They also address accommodative dysfunction, which refers to problems with the eyes’ ability to change focus quickly and sustain clarity at various distances.
They also manage strabismus, commonly known as an eye turn, and amblyopia, or lazy eye, which is a neuro-developmental condition where one eye fails to achieve normal visual acuity. These conditions can lead to poor depth perception and difficulties with visual processing. Furthermore, developmental optometrists treat visual issues resulting from acquired brain injuries or concussions, known as post-traumatic vision syndrome. Patients often experience symptoms like skipping lines while reading or headaches after sustained visual effort.
Core Principles of Vision Therapy
Vision therapy (VT) is the primary treatment method employed by developmental optometrists to address these functional visual problems. It is a non-surgical program designed to improve and strengthen the visual skills needed for comfortable and efficient sight. VT is often described as physical therapy for the eyes and brain, leveraging the principle of neuroplasticity—the brain’s ability to reorganize neural pathways in response to targeted training.
The program typically involves structured, in-office sessions, often supplemented by at-home exercises, which are conducted over a period of weeks or months. These sessions utilize a variety of specialized tools, including therapeutic lenses, prisms, filters, and equipment like the Brock string or computerized software. The goal is to retrain the brain to use the eyes more effectively, improving skills like eye tracking, focusing, and binocular coordination. For conditions like convergence insufficiency, research indicates that office-based vision therapy is the most successful treatment approach, leading to improvements in symptoms and visual comfort.