Behavioural Lens Trials: An Introduction

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By Charles Boulet

For vision therapy doctors of optometry, aka ‘VTODs’, lenses are one part of the treatment regimen for visual dysfunction. Sometimes they are used therapeutically then removed, sometimes they are palliative, and sometimes they are there to boost function in some contexts only. Some- times, lenses are not used at all and only visual rehabilitation is required.
There is little doubt that lenses are an indispensable tool for the behav- ioural/ developmental practitioner, the ‘low-hanging fruit’ of vision rehabilitation. This notion has been elaborated many times elsewhere since in literature, and most recently in a number of current volumes on vision rehabilitation.

Nowadays, we have an embarrassment of riches when it comes to lens designs and options. Still, if the goal is to meet the therapeutic and functional needs of the client, then we need to pay due attention in selecting lens options as a function of the patient’s visual pro le versus the visual nature of the tasks they are performing.

In my clinic and writing, I work to remain updated on new technology and never rest on what lens reps recommend. Every manufacturer, it seems, has ‘the best’ lenses, but it can be hard to notice the practical differences when compared side-by-side. Sometimes the best tools are the old tools. As a rule, I will not recommend a product I have not tried myself.
About 18 months ago, I began trials of new lenses to see what seemed to work best for my clients from recent offerings in ophthalmic optics technology, and for subsequent reference in my writing. I had contacted the big names in the lens industry and while they expressed some interest in this project, they insisted on restrictions on what I might write about: Either their products would be featured in isolation, or they could not ‘help’. In the end, I simply ordered what I needed and paid out of pocket.

Finally, in our trials, we considered manufacturer’s speci cation, patient visual functional status, sta opinions on their own experiences with lenses, and the patient’s visual tasking require- ments. In the coming four articles, I will review my favourites from this trial, and how I use these to address common clinical behavioural and developmental needs. We will consider specific lenses, coatings, and colour filters.

Dr. Charles Boulet began his professional career in education in 1990, a science teacher and early integrator of technology in the classroom.
His practice is in Black Diamond, Alberta. His background includes degrees in neural science and education from the University of Alberta, and a doctorate in optom- etry with a behavioural focus from Paci c Unversity. His paper on visual impediments to learning and development remains a common reference for therapists from, varied domains (http://oepf. org/ visual-impediments-to-learning/). An active advocate for higher child vision standards, he continues to consult and teach on child learning and behaviour concerns around the province and online.

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