VTOD.org Guest Editorial: IMHO (In My Humble Opinion) February 2009

Guest Contributor Kenneth C. Koslowe, OD, MS, FCOVDA
Senior Lecturer at Bar Ilan University School of Optometry and the Hadassah Academic College of Optometry, Israel

VT: An International Perspective

I have a somewhat unique viewpoint on Optometry in general and VT in particular having been educated in the USA and also having started my career there and then continued overseas. My generation has also seen the transition of Optometry from a drugless profession to a heavily medicated . . . or is that medical, one. It was my privilege to receive my VT education directly from Drs. Suchoff, Flax, Birnbaum, Forrest, and Fitzgerald along with some lectures from Drs. Gerry Getman and Amiel Francke. It is a sobering thought that today's VT Optometrists speak of (rightly so) some of my contemporaries such as Bob Sanet in the same way I speak of people who I thought of as giants (and still do).

There was a time about ten years ago when I started referring to ODs like me as the dinosaurs and felt that our "brand" of Optometry was on the verge of extinction. It seemed to me that VT had become virtually invisible in the USA and was too weak in the rest of the world to survive. Well I am glad to report that our "demise" was an illusion. Through the ceaseless efforts of many Presidents of the COVD in the USA and the work of Bob and Linda Sanet and Paul Harris overseas, I have witnessed the emergence of a newer and possibly even stronger version of Behavioral Optometry and Vision Therapy.

The Tour de Optometry, BABO-OEP, and the Sanet Seminars are important examples of this resurgence. Around the world we have seen evidence of the growth of VT in Australia, Italy, Denmark, Spain, Holland and even England. In my home country of Israel, VT is an important part of the curriculum and both schools have active VT clinics. IMHO this has arrived just in time. Ophthalmology, Psychology and Occupational Therapy are all (re) discovering the basic tenets of Behavioral Vision and Vision Therapy- visual skills play a critical role in learning, training the brain works better than cutting the muscles, wavelengths of visible light can play crucial roles in the ability to function. It would have been such a pity for Optometry to have given up on this part of its heritage just as others were eager take it.

This is certainly not the time to rest on our laurels. Our position still remains fragile, insurance companies do not accept many of our diagnoses, organized Ophthalmology has not stopped all of its attacks on us ("well maybe it works for convergence insufficiency, but not for anything else"). The newest "buzzword" - evidence based medicine, is being used selectively to attack VT even many older treatments have never been subjected to this standard of "proof." While I have always pressed for a more research-oriented Behavioral Optometry, this does not mean that we have to be held to a standard higher than that of other professions. The growth of VT worldwide has somewhat paralleled the growth in "alternative" health care. This can range from chiropractic to Bach flowers to iridology. Sometimes we are grouped along with these various alternatives. A question that needs to be asked is whether this is in our best interest. It remains my opinion that this "grouping" works to our detriment. While some of the components of this "alternative" group may have valid and provable points of view many of them are thinking so far "out of the box" that they are actually thinking "off the wall." This is my opinion and after all Bill did give me this editorial space to speak my piece.

In my view the road to our future success lies where it always has, in the Optometry Schools and in our educational conferences. Guest speakers spreading the word at each school are invaluable. However, only so much can be learned in your student days. One must deal with patients, succeed and also fail in order to start understanding VT. That is the point at which the meetings with ones peers and "elders" become so necessary.

So, keep treating, keep researching and get to those meetings as often as you can.