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RANZCO challenges evidence behind behavioural optometry

02/05/2018By Matthew Woodley
RANZCO has targeted behavioural optometrists with a statement that denies the existence of Irlen Syndrome and warns against what it calls “unproven vision therapies” offered as treatments for learning disabilities such as dyslexia.

The statement said there is no evidence behavioural optometry treatments help children with dyslexia and learning difficulties improve their reading, and that the college had an obligation to safeguard patients from treatments that lack clinical or scientific merit.


“Reviews of the literature have consistently shown a lack of good evidence to support vision therapies, such as those offered by behavioural optometrists, for the treatment of learning disabilities such as dyslexia.”
James Elder, RANZCO

“Ophthalmologists, like mainstream optometrists, are very passionate about saving sight and don’t like to see resources intended for health and wellbeing being misdirected. Reviews of the literature have consistently shown a lack of good evidence to support vision therapies, such as those offered by behavioural optometrists, for the treatment of learning disabilities such as dyslexia,” RANZCO's Associate Professor James Elder said.

“Using these expensive, ineffective and controversial treatments may delay a child from receiving the appropriate evidence-based educational remedies. Evidence shows that the earlier the intervention with the appropriate remedial programs, the more effective they are in improving reading outcomes.”

Elder also explained that, “The use of ineffective interventions may also waste the limited financial resources of the family as well as giving them a false sense of security that the child’s reading difficulties are being addressed.”

However, the Australasian College of Behavioural Optometrists (ACBO) responded by saying it was disappointed RANZCO had perpetuated what it said were mistaken and unjustified assertions related to behavioural optometrists treating dyslexia, and the validity of treatments such as vision therapy.

“ACBO members do not treat dyslexia or other learning difficulties. ACBO policy explicitly states that optometrists treat learning-related vision problems that occur concurrently with problems like dyslexia and can have a significant effect on visual performance and learning. Ophthalmology research has shown that children with dyslexia have a significantly higher incidence of visual problems than their unaffected peers,” the statement read.

“Clinical evidence for behavioural optometry and vision therapy is substantial and rigorous, and continues to expand with new generations of clinicians, academics and researchers. Treatments such as vision therapy are also recommended and offered by ophthalmologists and orthoptists.”

However, despite challenging RANZCO’s assessment of behavioural optometry therapies, ACBO said the college’s position had “largely agreed” with its own 2016 position statement regarding Irlen Syndrome and its related treatments.

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Irlen Syndrome

First described in the early 1980s as a perceptual learning disorder, Irlen Syndrome suggests that the brain is unable to properly process visual information from the eyes because of sensitivity to certain wavelengths of light. Symptoms are said to include poor concentration; difficulties with reading, writing and comprehension; glare sensitivity; headaches and poor depth perception, however RANZCO has stated there is no evidence that the condition actually exists.

“Clinical evidence for behavioural optometry and vision therapy is substantial and rigorous, and continues to expand with new generations of clinicians, academics and researchers.”
ACBO statement.

“The real concern with diagnoses of Irlen Syndrome is that it can distract from genuine diagnosis and treatment, such as a comprehensive evaluation by an educational psychologist followed by the appropriate remedial educational input,” RANZCO spokesperson Professor Frank Martin said.

“Any interventions that distract from and delay this evaluation could be detrimental to the effective treatment of any learning disabilities.”

According to RANZCO, treatments associated with Irlen Syndrome, such as coloured lenses, have not proved to be any more effective in improving reading difficulties in children than in children assessed in a control group.

While there is no documented evidence to say that Irlen lenses are harmful, the position statement went on to explain that their use could waste time and money, and substitute the use of evidence-based treatments.

“Overwhelmingly the research shows no benefit from this treatment in children with reading difficulties, and vulnerable parents are being exploited and having their children subjected to unnecessary screening practices,” Martin said.

More reading:

RANZCO Position Statement.

ACBO Response.

Image courtesy: Flickr | NicoleKlauss

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