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Working For The Department of Defense

Working For The Department of Defense

Originally posted on May 21st, 2013

I recently had the opportunity to be on a panel reviewing grant applications for the Defense Medical Research and Development Program (DMRDP), a core research program of the Department of Defense. These applications were for studying interventions to help veterans who had suffered traumatic brain injuries. Many of the projects vying for research money dealt with visual challenges resulting from traumatic brain injury. I have never been involved in research, but I thought it would be interesting to take part in this review process. I was mostly persuaded by the idea of providing the unique perspective of behavioral optometry for the purpose of helping those who bravely serve our nation to have a better life after sustaining devastating injuries.

Many service members are surviving from injuries that would have been fatal in the past. It is only a very few who fight for the rest of us and many of them are coming home wounded physically and emotionally. Traumatic brain injury is an all too common occurrence on the battlefield. Surviving traumatic brain injury is never easy. My experience in working with this population has been challenging, rewarding and often heartrending. One thing I know is behavioral optometry can offer what nobody else can when it comes to rehabilitation of the visual consequences of traumatic brain injury. These consequences include partial blindness, difficulty focusing, double vision, headaches, balance problems, etc.

I had hoped to see more attention paid to the importance of behavioral optometry's vast experience and expertise in proposals to study new technologies and interventions aimed at rehabilitation for our wounded warriors. I admit I am biased in my belief that behavioral optometry is the discipline with the most in-depth knowledge base of visual development, how to get the most therapeutic value from lenses, the intricacies of the visual process and the decades of clinical experience most appropriate to manage visual deficits resulting from traumatic brain injury. Few of the other doctors on the panel even knew of the existence of vision therapy and clearly those writing the proposals had no idea. This was frustrating to me since I have been treating people with visual deficits from traumatic brain injuries and concussions for over two decades. The interventions being studied would have gained much from including the perspective of behavioral optometrists.

The review panel was mostly made up of clinically experienced PhDs. I felt the most exciting and important members of the review panel however were three traumatic brain injured veterans all of whom were severely visually impaired. I found it inspiring and most helpful, in reviewing the potential impact the interventions being proposed, to hear the impressions of these vets. These men were not only injured but were all actively continuing to serve by being involved in helping their peers become re-integrated into civilian life after their active duty is over.

The medical community's continuing opposition to behavioral optometry serves no good purpose. I understand the importance of healthy skepticism toward unfamiliar philosophies and practices. Every time I begin working with a new patient, a unique individual each with his or her own unique set of circumstances, I have a healthy skepticism that I will be able to achieve what this person needs. Even though I have the greatest confidence in the work I do, and a darn good track record, if I do say so myself, I can never be certain that the next person who comes to me for help will turn out as well as the last one did. There is so much science proving that behavioral optometry is on solid footing. Most of this scientific evidence comes from researchers who do not even know what behavioral optometry is or what behavioral optometrists have been doing every day for seventy some years.

In 2010 neurobiologist Dr. Susan Barry stunned the scientific community by acquiring stereo vision (thanks to behavioral optometry) for the first time in her life at the age of fifty. Science said this was impossible, but behavioral optometrist Dr. Theresa Ruggiero thought otherwise. Nobel scientist David Hubel verified this incredible "miracle" causing him to modify the very scientific discovery that won him the Nobel Prize. “It had been widely thought that an adult, cross-eyed since infancy, could never acquire stereovision, but to everyone’s surprise Sue Barry succeeded." (David Hubel from the liner notes to Fixing My Gaze: A Scientist's Journey into Seeing in Three Dimensions by Sue Barry.)

The latest example of the medical community ignoring behavioral optometry has a newer twist. A medical doctor and researcher who has diligently ignored behavioral optometry recently "discovered" a therapeutic activity to help people with amblyopia or "lazy eye." This amazing discovery is nothing more than a common technique behavioral optometrists have known and used successfully in their therapy rooms for about sixty years. It’s a shame this clearly dedicated and curious doctor didn’t manage to find a single behavioral optometrist to talk to. One reason I gravitated toward specializing in behavioral optometry rather than just general practice was the kindness and generosity of the older practitioners I met as an optometry student. Every behavioral optometrist I’ve had the pleasure to have known over the last thirty years was always glad to share their knowledge with anyone interested in knowing what we do. All anyone has to do is ask.

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