We understand that neither pediatricians nor ophthalmologists have had the benefit of coursework in optometric vision therapy during medical school. But is it really that difficult to accurately represent the core concepts in our field? Once again, the Section on Ophthalmology of the American Academy of Pediatrics has trotted out a Joint Statement – this one in 2011 just two years on the heels of their last Joint Policy Statement. Enough with the Joint Policies already – even Goliath recognized when he was sufficiently stoned to move on. Listen, I’m as sympathetic to the Going Green movement as anyone else. But shouldn’t there be a limit as to how much the same item can be recycled? This latest Joint Statement has now taken on the air of science by calling itself a “Technical Report”, perhaps because it has added significantly more references than its forerunners, yet its agenda remains the same as its prior iterations: A shallow attempt to discredit optometric vision therapy, thoroughly exposed by Dr. Bowan’s rebuttal article published in the journal Optometry 2002, and by Dr. Lack’s rebuttal paper in the journal Optometry 2010.
The re-cycled and re-packaged Pediatrics/Ophthalmology Joint Statements are flawed for reasons that we have been very clear about. Given that the American Academy of Pediatrics, and specifically its Section on Ophthalmology’s “Learning Disabilities Subcommittee” chooses to ignore any legitimate criticisms of its Policy Statements published in peer reviewed optometric journals, perhaps we can make this a bit simpler to grasp.
Here is what we, in science, refer to as a Venn Diagram. Dyslexia is the subject in question, and it is a catch-all descriptor for a very heterogeneous set of reading disabilities . No onehas ever posited that dyslexia is “caused” by visual disorders, nor has anyone ever established that it is “caused” by auditory disorders. It’s treatment is therefore not strictly in the domain of vision or of audition or of phonology, or of any other singular approach. Optometry has been very clear about this, and the Venn Diagram you see was used by two leading physicians quite knowledgable in the field, devoid of politics and turf wars, who grasped this. Referring to the Joint Policy Statement of the American Academy of Pediatrics they note:
Although the authors of the recent consensus statement on Vision and Dyslexia were trying to clarify the most effective approach to diagnosing and treating visual processing issues in dyslexia, their statement is more likely to misinform than inform.
The public appears to have grasped the realities of optometric vision therapy far better than most pediatricians and ophthalmologists. They do not seek our services as a replacement for educational interventions, and they understand the cost of allowing their children to continue to struggle when other interventions have not proven effective. The deaf ear of the public to the distortions in the AAP/Ophthalmology Joint Statements seems to be prompting only more vigorous recycling, leading one to ponder what their true agenda is. The most accurate statement in this latest Technical Report may be a throw away disclaimer that reads:
The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
An optometric colleague, whose son graduated West Point a couple of years ahead of mine, summed things up succinctly after reading the latest Joint Report when he wondered aloud whether it wouldn’t be best if ophthalmologists advised patients prior to seeing them that vision plays little if any role in learning and reading disabilities from their perspective.
I was in attendance at my son’s graduation from West Point in 2004 when the Class was addressed by its commencement speaker, Donald Rumsfeld, then Secretary of Defense, and was moved by his remarks. I’m reading his memoir, Known and Unknown, in which he relates that if you’re not being criticized, perhaps it’s because you’re not doing much. We must therefore be having a significant impact on the field. That thought came to mind as I read the Joint Technical Report, as well as another thought prompted by Rumsfeld’s depiction of Ehrlichman in the Nixon White House, who seemed to have a high degree of certainty about his views that bordered on arrogance. Rumsfeld writes: Certainty without power can be interesting, and even amusing. Certainty with power can be dangerous. When it comes to second opinions about optometric vision therapy, caveat emptor.
– Leonard J. Press, O.D., FCOVD, FAAO