A History of Education in Behavioural Optometry
Up until the early 1960’s education in Behavioural Optometry was in the form of a professional continuing education programme. This programme did not have any academic recognition.
This all changed in 1963 when the first formal academic course in Behavioural Optometry was started by Dr AN Hafner at the Optometric Center of New York (OCNY).
Experienced behavioural optometrists would take a day out from full time practice to work in the teaching clinics of OCNY. In this way undergraduate optometry students benefited from the expertise of experienced practitioners.
In 1966 the State University of New York (SUNY) started a course in Behavioural Optometry and in 1974 the OCNY and SUNY courses were merged resulting in a year long course in ‘Optometric Vision Therapy’.
In order to establish an academically recognised qualification in Behavioural Optometry, COVD (The College of Optometrists of Vision Development) was formed in 1971. Their ‘Curriculum’ model of education had been devised and funded by a cross-section of Colleges and Universities of Optometry in America.
ASCO (The Association of Schools and Colleges of Optometry) were also involved so this qualification had widespread acceptance from a large number of schools of optometry.
COVD is the organisation with the most members with a recognised qualification in Behavioural Optometry (Fellowship of College of Optometrists in Vision Development: FCOVD). Most of its fellows are based in America and Canada though it also has members and fellows in other countries around the world.
Much work is required before applying for Fellowship of COVD and the Fellowship process, curriculum and certification examination are continually reviewed and updated by an International Examination and Certification Board (IECB). The current chairperson is Dr Kristi Jensen, Adjunct Assistant Clinical Professor at SUNY.
In America and elsewhere, attainment of Fellowship of the College of Optometrists in Vision Development (FCOVD) and Fellowship of the American Academy of Optometry (FAAO) are seen as a natural progression in professional development.
Details of the COVD Fellowship process can be found at https://www.covd.org/page/fellowship.
Australia and New Zealand
In Australia, the Australian College of Behavioural Optometrists (ACBO) was founded by optometrists Chris Henderson, Graham Peachey, Graeme Thompson and Bev Roberts. ACBO developed its own fellowship process which has always been run by ACBO themselves. In time, this fellowship process became an MSc in Behavioural Optometry at the University of New South Wales. Optometrists such as Mike Smith, Graham Peachey, Graeme Thompson, Sue Larter and Professor Ed Howell were involved in the development of the MSc programme.
The current ACBO Fellowship process takes approximately 4 years to complete. Candidates must have already completed the Masters units in Behavioural Optometry at the University of New South Wales in Sydney as well as all four of the OEP Clinical Curriculum Courses (Art & Science, VT1: visual dysfunctions, VT2: learning related vision problems & VT3: strabismus and amblyopia).
Details of the ACBO fellowship can be found at https://www.acbo.org.au/images/Education/ACBO_Fellowship_June_2018.pdf
The Australian fellowship course has recently been shut down due to political pressure from ophthalmology in Australia.
Continental Europe
Spain
Behavioural Optometry has been taught in Spain since 2002 when Dr Pilar Vergara started teaching the principles of Behavioural Optometry at the Optometry School in Madrid. Dr Vergara has also worked with the Spanish Olympic Shooting team. Bob and Linda Sanet from San Diego, California and Stefan Collier from Switzerland have also been involved in educating Spanish optometrists.
In 2020 a Master’s course in Behavioural Optometry started at the Universitat Polytècnica de Catalunya in Barcelona. This course is run by Nὐria Baldrich Roure and Aurora Torrents Gόmez.
This Master’s course takes nine months to complete and involves 330 hours of tuition. Lecturers include John Abbondanza, Adjunct Professor at the Southern College of Optometry, Memphis, Tennessee and Curt Baxstrom, Adjunct Professor at the Pacific College of Optometry in Oregon.
Another course in Behavioural Optometry started in 2020 at Castellón de la Plana near Villarreal entitled ‘Masters in Clinical Optometry and Vision Therapy.’
In Spain, behavioural optometrists work alongside ophthalmologists in hospitals in the co-management of patients including patients with strabismus, amblyopia and brain injury.
Italy
Behavioural optometry forms part of the Optometry degree in Italy so Italian optometrists have some knowledge of the theory and practice of the discipline. Dr Vittorio Roncagli founded a European Sports Vision association in 1988 and has been researching the visual efficiency of people playing both competitive and recreational sport for over thirty years.
Dr Roncagli has also studied the impact of vision on childhood development and has written textbooks on childhood development with Dr Vania Galbucci who specialises in the study of motor movement of children. These books include a description of the importance of a child’s posture when writing, the lighting used in the classroom and the way a child holds a pen.
Paolo Tacconella FCOVD runs his own courses on vision training and vestibular function in Italy and runs a clinic working with children with learning difficulties.
Cristina Toffoli runs a similar clinic for children with learning difficulties in Cuneo in Northern Italy.
Hungary
In Hungary, Fabrizio Bonci, a graduate of the Optometry School in Rome and former researcher and clinician at the Department of Neuroscience and Mental Health at Imperial College, London uses the principles of behavioural optometry in the treatment of patients with acquired brain injury at the Ocular-Optikus Eye Clinic in Kecskemét. He also works with in general practice with patients with learning problems, squints and lazy eyes as well as lecturing in functional optometry, vision therapy, paediatric optometry and geriatric optometry.
Fabrizio Bonci is also a member of the Clinical Editorial Board for the Italian Journal of Optometry as well as being a Clinical Lecturer at the College of Italian Optometrists, Milan (ITA).
He has introduced new concepts regarding the treatment and examination of binocular vision patients in Hungary as well as designing a functional protocol for the treatment of such patients that follows international guidelines.
Belgium
In the past, behavioural optometry has been taught to Optometry undergraduates in Belgium by Dr Guy Naegels. Other Belgian colleagues include Dr Bernard Cassiers, Benoit Lombaerts and Ms Kim Rooms whilst Sofie De Witte teaches vision therapy at Odisee in Brussels.
The optometry schools in Belgium have recently been closed down and replaced by an ‘eye care’ course at Odisee. This course is orthoptics and optometry combined and is arguably a ‘dumbed down course’ to suit ophthalmology in Belgium. Vision therapy is an optional part of the course.
France
In France an exchange programme has been running between France and Australia since the early 1990’s. French optometry graduates contact Françoise Rateau, Professor Ed Howell’s clinical associate in Melbourne.
Placements are then organised at Professor Howell’s practice. One particular French optometry graduate who has participated in this exchange programme, Jean-Baptiste Fouroux currently works in practice in France as well as working with the French national rugby union team.
Portugal
In Portugal Sérgio Marques uses the principles of behavioural optometry to work with patients with learning problems, squints and lazy eyes. Sérgio also works with patients with back pain in order to work on visual causes of their postural difficulties and at one time worked with the football team FC Porto improving the performance of their first team squad including a certain Radamel Falcao.
The UK
The British Association of Behavioural Optometrists (BABO) was formed in 1991 by an optometrist, Keith Holland. BABO has its own fellowship process. Much like the original OEP training programme this does not have any formal academic accreditation or backing of UK optometry schools as of yet.
Members of BABO have been involved in teaching at UK Optometry schools at both the Aston and Manchester Optometry Schools. Some of the undergraduate students who have studied at these institutions will therefore have some knowledge of Behavioural Optometry.
Behavioural Optometry has also been taught at the School of Psychology at the University of Birmingham since 2010 as part of an MSc in Brain Injury Rehabilitation.
Scandinavia
Behavioural optometry has been taught in Scandinavia by Paul Harris from the Southern College of Optometry in Memphis, Tennessee and Steen Aalberg who is based in Denmark.
Other parts of Continental Europe
In Switzerland, Germany, Austria, Slovenia, Holland and Italy interest in behavioural optometry is growing due to the influence of BOAF (The Behavioral Optometry Academy Foundation) under the tutelage of Stefan Collier and Jurgen Eichinger.
This organisation has no academic accreditation or backing of European optometry schools as of yet.
BOAF has speakers from around the world speak at their conferences including Curt Baxstrom, Jason Clopton, Ray Gottlieb, Samantha Slotnick, Larry Wallace, Bob and Linda Sanet and Debbie Zelinsky from America, Tricia Fink from Canada and Geoff Shayler from the UK.
South East Asia
In Malaysia, Stanley Tien, a graduate of Cardiff University Optometry School teaches the principles of behavioural optometry at the National University of Malaysia.
Yap Tiong Peng performs a similar role in both Singapore and Malaysia.
Chan May May also practices behavioural optometry in Penang in Malaysia.
South America
Behavioural optometry seminars have been taught in Brazil by Bob and Linda Sanet, Pilar Vergara and Salvador Perez.
Scientific publications
As regards scientific papers, COVD publishes a quarterly optometric journal entitled ‘Vision Development and Rehabilitation’ which is currently edited by Dr Marc Taub at the Southern College of Optometry in Memphis, Tennessee.
ACBO emails out ‘educational updates’ as regards scientific papers validating the practice of Behavioural Optometry.
In Spain the Spanish General Council of Optometrists publishes a double blind peer-reviewed publication entitled ‘Journal of Optometry’.
In Italy the Italian Optometric Association publishes a peer reviewed publication entitled ‘Rivista Italiana di Optometria’.
Peer reviewed scientific papers are considered to be the ‘gold standard’ as regards scientific research.
Both the Spanish and Italian journals are published in both Spanish and Italian respectively as well as in English.