(See the Preface here.) There are many uses of the word ‘blind’. The concept is so broadly understood, and feared, that many languages have adopted the term to other common uses. When someone does not appreciate the gravity of a situation, they are said to be ‘blind to it’. Likewise, we are blind when we can ‘see’ a threat, as in perceive it and understand it, but refuse to act on it. Even in more technical arenas, the word is helpful in many contexts. Anosmia, for example, the inability to smell, is often called ‘nose blindness’. Face blindness, clinically speaking, is referred to as prosopagnosia – blindness here being the more widely recognizable term.
This and the following three posts describe ‘vision blindness‘, a term coined to complement the standard understanding of visual blindness. In medicine, ‘blindness’ is most often used in the traditional sense: The inability to see due to disease in the eyes and/or visual neural pathways. To simulate this in a crude and rudimentary manner, one simply has to close the eyes. Vision blindness, on the other hand, is the inability to understand visual process, visual impediments to learning and development (VILD), and how these impact upon human development and behaviour.
Unless you have training in vision science or you know you are affected by visual impediments, you are likely to be ‘vision blind’: To you, your eyes ‘just work’, and your vision, for all intents and purposes, is ‘normal’. The impacts of vision blindness among clinical practitioners are most often felt by the patients they serve; this disregard leads us down sub-optimal, and sometimes dangerous, paths of assessment and intervention when faced with many common medical and child development concerns. When we ignore the basics, it becomes easy to convince ourselves that something else is amiss, something that we can search for and speculate upon until the proverbial cows come home, but none of these avenues of inquiry will lead to underlying causes and effective treatment because the root problem, visual dysfunction, has not been addressed.
Vision is a process that begins in the eyes or in the brain, depending on context, and whom you ask. Regardless of your frame of reference, there is no disagreement that vision, that is, the details of the visual process, are extraordinarily complex and understood by very few. There are multiple professional specialties that deal with the many aspects of vision, from eye physiology and medical care, to visual perception (so-called visual processing), to visual performance in sport and rehabilitation, to physiological optics (the process of capturing optically-based stimuli with the eyes), to visual rehabilitation.
Regardless of the massive complexity of vision and the visual process, vision can also be perceived as fundamentally simple: You open your eyes and there you have it – it works. This simplicity combined with the great underlying complexity creates a paradox: For some, vision becomes something we don’t need to be concerned with, and for others it is critically central in child development and the care of some patients. Given the arcane and complex nature of vision science, it is no surprise that many who should know the details don’t. What is more surprising is that many who know they know little, and should know more, do nothing to expand on that knowledge.
In the Part One, I will consider the vision blindness that results from lack of professional expertise and training. Too few professional programs in health, education, and psychology take time to teach even the fundamentals of how vision works and why this is important. This provides a foundation for misunderstanding and creates an extreme bias in patient care that leads to inefficient care, and at times dangerous and unnecessary interventions.
Part Two takes a look at vision blindness resulting from what don’t see about vision because we don’t look. This is closely related to the the first concern described in Part One, the fact that professional colleges disregard human visual function in their curricula, but it also extends further into practical clinical applications: How does the lack of curricular emphasis on vision function manifest in clinic day-to-day?
The final post, Part Three, considers those instances of vision blindness where, for a variety of reasons, doctors and therapists choose to not consider visual process in their diagnostic and treatment regimens, choosing instead to seek alternative and more common clinical paradigms. This includes those who work to minimize the importance of human visual function, while having no expertise to speak from in this regard.
These three perspectives, the “cannot’s”, the “do not’s”, and the “will not’s”, all combine to create a great gap in the management of health, education, and child development. The resulting disregard of something so very basic to our existence and development is often catastrophic for those afflicted with significant visual functional problems, their families, and to the taxpayers who fund public education and healthcare. The point of these posts is, I hope, clear; the reason why I would write them is elaborated in the series Preface.
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