History of Behavioural Optometry

The Founders of Behavioural Optometry

The principal founder of behavioural optometry was Arthur Marten Skeffington, an optometrist from Nebraska in America.

Skeffington had noticed ‘patterns’ in the clinical findings of his patients in everyday practice. For example, he noticed that when his patients were doing too much close work, their focussing would become tired and their eye coordination overworked.

This happened before these people required glasses to correct their eyesight.

Skeffington would prescribe glasses to these patients in order to relax their eyes. He would also give them exercises to encourage their eyes to focus or coordinate better so that they felt more comfortable when performing their work.

Glasses prescribed in this manner were termed ‘compensatory’ or ‘therapeutic’ glasses differing from ‘corrective lenses’ that correct your eyesight that most people are used to.

Alexander, another optometrist took interest in Skeffington’s work and by working together in 1928  formulated a course called the ‘The Optometric Extension Program’ otherwise known as ‘OEP’.

This was an educational programme devised to educate other optometrists about this new concept of ‘Behavioural Optometry’.

Skeffington was considered to be more charismatic than rigorous in his teaching so in the early 1930’s Alexander, by now vice-president of the American Optometric Association (AOA) had Borish (who went on to become one of the greatest minds in modern day optometry) work with Skeffington in order to refine this teaching.

Working together with Skeffington, Borish translated Skeffington’s teachings into a form that could be more easily understood by optometrists.

Borish’s work formed the basis of the OEP education programme and Borish was subsequently invited to become chief lecturer for OEP. However he decided to take other opportunities instead and the invitation was instead taken up by an optometrist called Gerry Getman.

Gerry Getman would later inspire optometrists Graham Peachey, Chris Henderson, Bev Roberts and Graeme Thompson to form the Australian College of Behavioural Optometrists (ACBO) in 1987. This group would later work with Professor Ed Howell of the Victorian School of Optometry in Melbourne, Australia to refine the academic content of their teaching.

In the early days of behavioural optometry, other great minds were involved in the development of the education programme, most noticeably Samuel Renshaw and Darryl Boyd Harmon.

Samuel Renshaw was a Professor of Psychology at the University of Ohio and his most famous work was that of being credited with the saving of countless lives during World War II. This was due to his work with the US Navy.

Renshaw had already performed ground breaking work on ‘tachistoscopic training’ where subjects were exposed to a series of numbers flashed on a screen for increasingly shorter periods of time. As a result of this training the subjects could read text faster whilst maintaining the same level of comprehension.

Howard Hamilton, a naval officer and former University of Ohio employee saw the military potential of Renshaw’s work. At the time the Allies were losing many soldiers and much equipment because naval personnel were too slow or too inaccurate in identifying enemy ships and planes.

In 1942, the US Navy worked with Renshaw to establish the ‘Renshaw Training System for Aircraft and Ship Recognition’. Using Renshaw’s tachistoscopic training methods officers were taught to identify planes and vessels as a ‘gestalt’ with a ‘total perception of form’ in a fraction of a second.

It is estimated that over a million army and navy personnel were taught Renshaw’s methods leading to the saving of countless lives. Renshaw was subsequently awarded the Distinguished Public Service Award, the Navy’s highest civilian honour. Some of Renshaw’s scientific papers are housed at the Archives of the History of American Psychology.

Darryl Boyd Harmon was considered to be a polymath, respected enough to present at meetings of the American Academy of Paediatricians, the American Optometric Association and the Massachusetts Institute of Technology (MIT). Later in his career he directed the Environmental Design Centre at the University of Wisconsin for graduates in architectural, landscape, urban, regional, industrial, interior and engineering design.

Harmon’s interest in optometry came from a wish to improve the education of children.

Harmon felt that some classroom imposed postures were not good for children so performed research into how lighting affected posture, how the quality of the light spectrum influenced visual recognition and what were the optimum lighting levels for sustained visual performance.

Harmon also became a consultant to manufacturers of seating, lighting and paint colours in classrooms.

Harmon also came up with the idea of what has now become known as the ‘Harmon distance’ that is holding any close work at an elbow to knuckle distance.

Harmon felt that holding reading material or electronic devices any closer than this could potentially lead to eyestrain.

Harmon also promoted the use of sloped desks so that children were more likely to sit upright rather than lean over their work when doing close work.

We naturally tend to place our heads parallel to whatever we are looking at. So, when work is flat on the desk we tend to lean over in order to get our heads parallel to the plane of the paper. In doing so, we get closer to the page and are more likely to strain our eyes.

When we work on an inclined surface such as working on a sloped desk or by placing an A4 file underneath our work we are more likely to sit up straight and work our eyes in a more relaxed manner. Our hands are also in a more relaxed position.