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Introduction to Dr. Gallop’s Book

(If you would like to buy the book but don’t want to pay electronically, Contact Me)

An optometry student reviews Looking Differently at Nearsightedness and Myopia

by Dr. Steve Gallop, Behavioral Optometrist:

I have read through this book and really enjoyed the ideas that the author conveyed. Reading this (and spending time talking with Dr. Robin Lewis and Dr. Howard Bacon) has completely changed the way I look at myopia and prescribe lenses. In school, I understood that myopic individuals would most likely progress in the adolescent-teenage years, and the only option was to prescribe according to the “numbers.” Myopic myself, I have experienced this pattern firsthand, and I would have appreciated my optometrist offering options, such as presented in the book, that may have controlled my myopia progression, or prevented it altogether. I have already encouraged classmates to read the book–it is well written and eye-opening for many of us that have not considered there may be another option.

Robyn

Book Introduction / Excerpts
The core material in this book was originally published as an article in the Journal of Behavioral Optometry to help educate professionals who provide eye and vision care develop a broader perspective on nearsightedness and lens prescribing in general.  Very few doctors show interest in understanding the complexities of the visual process or the real needs of people who must wear glasses or contact lenses.  The standard eye exam is done to make sure the eyes are physically sound and that one way or another the person can see 20/20.  20/20 (which is average, not perfect) visual acuity is a very small part of the overall visual process.

20/20 is average visual acuity, which is a very small part of the overall visual process.

Over 100 years ago, a small number of people were tested for clarity of eyesight (visual acuity).  On average they were found to be able to recognize a certain size letter (1/3 inch) at a certain distance (20 feet).  This became the expected measurement and remains so today.  The standard lenses that result from such an eye exam are the lenses that cause the 20/20 line on the eye chart to be clear.  There are other ways of investigating a person’s visual circumstances and needs.  Different philosophies exist and these philosophies can lead to drastically different conclusions and treatment options.
There are three major categories of “eye care” professionals: optometrists, behavioral optometrists and ophthalmologists.  Doctors of optometry, optometrists, (OD) are trained to diagnose physical and functional diseases of the eyes and are trained to prescribe lenses and prisms.  In the past decade or so the optometric profession has gained the right to treat certain physical diseases of the eyes using medications.  The vast majority of optometrists have chosen to embrace these new privileges so that their style of practice more closely resembles that of ophthalmology.  Ophthalmologists are medical doctors (MD) who specialize in physical diseases of the eyes, most commonly with medication and/or surgery.  They are also permitted to prescribe lenses and prisms.
Behavioral optometrists are optometrists who devote at least some percentage of their practice to actively diagnosing and treating functional diseases of the eyes.  Functional diseases of the eyes include lazy eye, crossed eyes and wall-eyes.  Many forms of nearsightedness and farsightedness can also be considered in this category.  People of all ages with functional vision problems often experience some interference with comfort and performance as well learning problems such as attention deficit, dyslexia and various other so-called learning disabilities.

Young people with functional vision problems often experience learning problems such as attention deficit, dyslexia and various other so-called learning disabilities.  

Ophthalmologists and optometrists typically provide compensating lenses, which they refer to as “corrective lenses” – this is a meaningful issue and will be addressed later.  Compensating lenses are based solely on the ability of the wearer to read the 20/20 line on the eye chart.  Behavioral optometrists may prescribe therapeutic lenses and prisms to alleviate certain problems by dealing with the causes.  These lenses may be referred to as developmental lenses, learning lenses, counter-stress lenses or stress-relieving lenses.  Behavioral optometrists may also provide visual training, a program of visual activities designed to stimulate the visual process within the brain.  Visual training will also address the causes of the problem and usually lead to an elimination of symptoms.

Behavioral optometry is based on the knowledge that vision is a dynamic process that develops throughout our lives.  The visual process is trainable, and can be enhanced using therapeutic lenses and/or visual training.

People contact behavioral optometrists every day to find out if they can get rid of their glasses, or reduce their dependence on them.  Behavioral optometry is based on the knowledge that vision is a dynamic process that develops throughout our lives.  The visual process is trainable, and can be enhanced using therapeutic lenses and/or visual training.  Based on more than ten years of professional experience, I would have to say that 80-90% of the people I examine come into my office wearing lenses that are too strong for most of their daily activities.  Most of these people could still see 20/20 with weaker lenses.  Standard compensating lenses have many negative visual side effects.  They cause decreased visual performance in ways that we do not typically realize.  When I say we, I am speaking from the point of view of the average eye doctor as well as the average patient. 

Various complaints like headaches, muscle tension in the neck and back, eye discomfort, falling asleep when reading, and many others are often directly related to how we use our visual process.  Standard glasses and contact lenses, more often than not, are directly related to these issues.  These visual side effects often lead to other problems.  Also, many people are clearly hindered by their standard lenses.  It is clear that for some people with multiple visual issues, the lenses that provide the clearest artificial eyesight cannot possibly provide optimal comfort and overall performance.  It often requires a little creative thinking to help people get the most out of their visual process.  The standard teachings and practices cannot do the trick in many cases.  This is probably true for many more people than one would expect.  In fact, people are often unaware that their complaints are related to their vision or their glasses.

I had the good fortune to attend the 1999 Natural Vision Improvement Symposium.  Speakers included behavioral optometrists, ophthalmologists and lay practitioners.  Some were well known within the complementary health field, others were newer to the field.  There were many approaches being offered for the purpose of reducing nearsightedness.  Some focused on dealing with emotional issues, some on meditation, some on nutrition.  Most incorporated all of these issues to some degree.  I have investigated many of these programs over the years and I have a pretty good sense of the strengths and weaknesses of the various approaches.  In fact the discovery of these very programs led me to consider becoming an optometrist in the first place.  In looking at the various options, I decided that the best way to get the most information from all sides was to become an optometrist.  The path was not as direct as I originally thought, but I believe my goal was achieved. 

For the most part these non-optometric programs have something to offer.  Apparently each program was started by an individual with his or her own success story in dealing with nearsightedness or some other visual condition.  Most of these programs include some type of visual hygiene, breathing, acupressure and/or massage techniques.  In general they all offer relaxation techniques and variations on activities attributed to W. H. Bates in the early 1900s.  Bates, an ophthalmologist, was perhaps the first to expand the ideas of vision care beyond the optical system of the eye.  He believed that the function of the eye itself was more complex than was commonly held within his profession.  He also felt that the visual process was something that could be improved with a training program that included relaxation and awareness techniques.  For the most part, the work seems to center around eye muscles and visual acuity.  Bates designed activities and trained instructors to help people eliminate their need for glasses.  These instructors trained others, many of whom have since developed their own variations on what is known as the “Bates Method.”

All of these programs require a fair amount of diligence and discipline.  The programs are to be carried out by the individual simply following the directions in the book and/or accompanying tapes.  The authors typically recommend that an optometrist be contacted only to get a reduced prescription.  Obviously that would be discouraging to me as a behavioral optometrist.  However, the most disappointing thing I have found is that these practitioners place too much emphasis on visual acuity, the eyeball and the muscles in and around the eyeball as a key issues and therefore the focus of the program for change.

While Bates was unquestionably a pioneer in terms of looking at the visual system differently, he only glanced at the tip of the iceberg.  Remember his work was done early in the 20th century and much has come to light since that time.  Interested behavioral optometrists have expanded the concepts to a degree that is analogous to comparing the pioneering work of Magellan to the Voyager mission through the solar system.  Bates made a quantum leap with his ideas.  He no longer accepted the mechanical/optical view of the eyeball as being the only aspect of the visual process worthy of investigation and treatment.  He was convinced that the visual process was a dynamic one which was amenable to change and improvement if a person had a notion to work at it.

As a believer in the importance of options I am glad that there are choices available to the general public.  It is difficult to find doctors who will truly listen to what we say as patients.  It is not always easy to find the right practitioner who can answer our questions in order to get to the root of the problem.  As an experienced patient, therapist and practitioner, I feel it only fair to say that when I wanted to get the most thorough program I went to a behavioral optometrist.  Non-optometric practitioners, while well meaning and generally quite capable within their knowledge base, are not trained in fully evaluating the visual process.  They may be able to guide you in reducing your prescription and increasing your visual acuity, but they may not be fully aware of all the factors involved in providing the most comprehensive visual enhancement program.

Many of my patients have read this article over the years and found it to be informative.  However, it eventually became apparent that the original article contained too much technical language to be of maximum value.  In this expanded version I have tried to make it more useful to the general public.  Because most professionals are unaware of the issues involved, most patients remain similarly uninformed.  This means that many people are not receiving the highest level of care available.  Hopefully this book will provide some food for thought for people who have already had experience with the standard approach to eye care.  I’m sure there are still some terms and concepts that that may not be common knowledge.  If these have not been described adequately in the body of the text, they will likely be found in the glossary.

There are very few facts in this world, but many concepts, ideas, notions, and perceptions.  What follows is based on personal experience, first as a patient, then as a caregiver.  These are my experiences and insights based on more than 30 years of wearing glasses, and over 10 years of helping people deal with their own visual needs and desires.  Although this book mainly addresses the issue of nearsightedness, people with farsightedness and astigmatism will find this information to be just as pertinent.

These are my experiences and insights based on more than 30 years of wearing glasses, and over 10 years of helping people deal with their own visual needs and desires.  Although this book mainly addresses the issue of nearsightedness, people with farsightedness and astigmatism will find this information to be just as pertinent.

Very few doctors seem to appreciate the complexity of vision.  The vast majority of lens prescriptions (for those under the age of forty) are based on reading the 20/20 line on the eye chart.  Any time a person wears lenses there are numerous changes that occur.  Obviously a lens changes the way light is focused.  Lenses also change the perceived size of things as well as the perceived distance of things.  There are other more subtle changes that occur when viewing through a lens – these will not be addressed here although they can have significant impact on the visual process. 

The standard eye exam does not address a person’s real everyday visual needs.  Therefore, very few people are wearing the lenses that best serve their overall day to day performance.  Lenses that are optimal for the overall comfort, efficiency and protection of the visual process will usually be weaker lenses than those required to read the bottom line on the eye chart. 

I still recall the look of horror on my eye doctor’s face when I asked him to give me lenses that were weaker than those he wanted to prescribe.  It remains difficult to find a practitioner who will grant such a request.  These issues still generate considerable resistance among the vast majority of eye care professionals.  Most doctors do not see the significance of a more thorough evaluation, and base their prescriptions on the eye chart alone.  It is becoming necessary for each of us to have greater understanding of what is available to us in the world of health care.  I hope what follows will enable you to make more informed decisions about your own eye care.