Vision Blindness Part 3 – What we won’t see.

(See Part 2 here.)

In the Preface to this series, I mentioned how I’ve been personally attacked for my advocacy for better (any) standards for children’s vision needs. No, I don’t have a saviour complex, and would much prefer to spend my nights in a sound sleep after numbing my brain with some Netflix binge watching – but instead, I write, plot and scheme: Kids will succeed better when we attend to their very basic needs first, and we will all pay less as taxpayers. Happy_elephant

The science of vision is there to show us that children with even garden-variety hyperopia and astigmatism struggle at even low values, and that non-optical vision concerns are cause for distraction and reduced performance in the classroom. These are by no means unique studies, but they are recent and more relevant given the increased visual demands of the neo-traditional classroom. Refractive state is easy to ‘see’ as a problem when a myopic child squints to see the whiteboard, and no doctor will discourage lens ‘correction’ at that point. What we don’t see is that in doing so, we often remove the advantage myopia confers on the child: Mild myopia is a gift in the classroom that is centred around near work. ‘Correcting’ for it means the child now experiences greater strain at near distance. For the hyperopic (farsighted) child, an equivalent amount of ‘correction’ would typically not be offered because the child appears to ‘see’ just fine at distance, but it is this invisible case that we must be more concerned for, or so say science and clinical experience.

So, if science and clinical experience tell us we ought to offer compensation for hyperopes and astigmats, and that overburdening a child with these leads to cognitive and behaviour problems, then why would child development professionals pay no attention to it? As mentioned in Part 1, refractive state is pretty basic, but it remains only one portion of the entire visual functional profile.

Erika Schwartz, MD, has outlined some elements of modern Western medical practice that apply here in her recent book “Don’t Let Your Doctor Kill You: How to Beat Physician Arrogance, Corporate Greed and a Broken System”. These are summarized in a post by Dr. Len Press:

  • Physicians are now being taught to follow protocols, “evidence based medicine” and act robotically, almost thoughtlessly in group think fashion when treating patients.
  • Those who don’t follow the party line established by medical societies are quickly marginalized from the system and become outsiders.  They are considered alternative, unacceptable to the mainstream and labeled quacks or snake oil salesman with impunity and venom.
  • When outliers raise valid questions and challenge the wisdom of the status quo, the indoctrinated mainstream physician is conditioned to automatically reject the validity of an opposing point of view.
  • Physicians for the most part are skeptics who don’t listen – a deadly combination.

In Part 2, I called this a ‘field distortion’, a term used by Steve Jobs and others to describe how our beliefs interfere with the perception of the reality around us: In this case, the reality that vision matters and that in a highly visual classroom, visual dysfunction is a serious concern for many students. Part 1 describes how much of this problem comes from a need for better curriculum in professional colleges of education, medicine, and psychology: ‘We can’t know what we aren’t taught’. The remaining vision blindness in our ‘child development industry’ arises from an active unwillingness to learn and to see. This is prevalent to the extent that I’ve had doctors and government officials tell me vision doesn’t matter, or that ‘Vision Therapy (aka Vision Rehabilitation) doesn’t work.’ These same people have never had the honesty or integrity to sit across from me and explain their positions, and explain what ‘vision rehabilitation’ entails. They have often drawn from the same obscure and irrelevant research to support their position, and this has had the corollary effect of proving their lack of knowledge and experience. None of these critics can explain the functional difference between myopia, hyperopia, and astigmatism, or even begin to describe what ‘vision’ is. It is unlikely these people would ever be comfortable discussing these principles while wearing uncompensated 2D of hyperopia or astigmatism. One can only assume they would refer themselves to an MRI for investigation of their headaches.

The irony is is that school officials and psychologists will reflexively refer to Occupational Therapy for work on ‘vision’ or ‘visual perception’. Somehow, vision becomes relevant when another non-vision professional makes a recommendation, but it is a truism that these visual assessments are often of little use. Furthermore, it is precisely these OT’s that call upon myself or my colleagues for help: “What do we do now?”, they ask.

No school division in the Province of Alberta is required, or even interested, in tracking what children’s visual status is: Not if they’ve had an eye exam, not their refractive state, nothing. After some protracted and famously toxic exchanges between myself and a regional school superintendent over the lack of attention to vision in his schools, and his staff’s threats against me, he finally relented: “Yes, ok, it might be a problem, but it’s not our responsibility.” At last, an honest response. Now we’re getting somewhere.


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