In the first instance it is important to state, we use a standard approach and look for standard solutions as far as lens prescribing goes. This is faster, takes less assessment time and follows a direction that is well understood and gets agreement amongst eyecare practitioners.
Another point is making sure that there are no underlying eye health issues that needs tertiary care from an ophthalmologist (a medical eye specialist).
Some of the symptoms we ask about are not necessarily vision related or an eye problem. We also inter refer with occupational therapists, physical therapists, educational specialists and psychologists as appropriate. The approach is not ‘one size fits all’; when the brain, nervous system and adaptation strategies get involved, symptom presentation can become very non-linear but still have a significant effect on quality of life.
In terms of standard solutions, a lot can be gained by doing the basic optical dispensing correctly: a thorough history, talking to your patient and a properly fitted pair of glasses goes a long way. The spectacle frame is suitable, an appropriately chosen lens design with the lenses fitted accurately in the frame are important.
Some lens types that we use:
- Cerium Precision tints and FL 41 tints
- Prisms of different kinds
- Prescription modifications
- Plus lenses at near
The type of clientele we commonly see include those who are visually sensitive, post traumatic brain injury or where their visual system has decompensated due to health, aging and metabolic reasons. Our testing is primarily directed towards assessing subtle accommodative convergence issues (especially at near), pattern glare and vision vestibular (balance) connections. Resulting in reading problems, balance and spatial anxiety and rapid fatigue amongst others. Symptoms are subjective – we assess from a functional (neuro) paradigm and sometimes a problem is hard wired or structural and a functional vision approach is not appropriate. Assessment routines are our interpretation of ideas developed over decades by the Optometric Extension Program (OEP), the Australasian College of Behavioural Optometry (ACBO) and the College of Syntonic optometry (CSO).