The drive to have optometric office “go paperless” has been a clarion call since 2001, heralded in publications such as Optometric Management. The high tech environment many of us live in certainly puts peer pressure on considering paper-driven records and non-computerized assessment and treatment as dated in some ways. 18 month old patients are coming into the office playing and learning on their parents’ iPads. We seem to have skipped right over the Fisher-Price version, and accelerated directly into the real thing. Yet there are still very important applications of paper that cannot yet be replaced with their electronic versions.
We’re all in transition from older ways of doing things in the office and at home to newer things. In optometric vision therapy we continuously weigh the computerized versions of assessment and procedures designed to enhance, if not advance their low tech antecedents. From the Visagraph/Readalyzer for eye movements to open-view autorefractors for accommodation, diagnostic insights are extended. From the HTS family of programs to the in-office SVI and NVR programs, therapy becomes more interactive and feedback is enhanced. Yet it is good to bear in mind that technology is not a substitute for an engaged doctor-therapist-patient relationship.
Last week I referenced a new work, Plasticity in Sensory Systems, which I received in the mail yesterday. Not the ebook version, but the good ol’ hardback paper version. I know that ultimately I’ll be doing the same kind of highlighting, underlining, dialoguing with the author, and generally immersive reading that I currently do with print version on electronic versions. But at present my mind still engages more readily paper version. Not exclusively, of course, or else you wouldn’t be reading this is an electronic format. The chapter I was looking most forward to reading (though I was pleasantly surprised by some others) is the one by Susan R. Barry entitled Beyond the Critical Period: Acquiring Stereopsis in Adulthoood. Among Sue’s many great insights, in this context I want to highlight the one with which she finishes her chapter: “No two individuals adapt to their visual disorder in exactly the same way. To harness adult neuroplasticity for visual or any other type of rehabilitation, one needs a highly motivated and engaged patient and a doctor or therapist with enough knowledge, experience, and flexibility to tailor therapy programs for each individual. The best therapies are those that provide novelty and a sense of reward, and that train skills that are more easily translated to everyday life. Once we focus our efforts on designing effective therapies, ones that match the individual’s needs, strengths, routines, and experiences, we may witness neurological recovery in ways that were once thought impossible.”
To be paperless or not isn’t the essential question. Add this to the list of items for which we say it isn’t the tool that matters as much as what one does with the tool. This applies to the doctor as much as it does to the therapist and the patient. Le papier ne sera jamias mort! Ne c’est pa?