A Pair of Dimes Shift …


Okay, it’s time to get serious.  We’re finally seeing a shift in the paradigm of vision in a Kuhnian sense

kuhn cycle

I blogged last week about the amazing book co-edited by Gordon Dutton, a pediatric ophthalmologist in Glasgow, Scottland, who is doing a phenomenal job of bridging the eye-brain gap in practice.  It is worth highlighting a fact that continually gets lost or glossed over, so let me shout it out in caps:  THE EYE IS PART OF THE BRAIN.  In particular I like this quote from Penn Medicine:  “The retina is actually a piece of the brain that has grown into the eye and processes neural signals when it detects light. Ganglion cells carry information from the retina to the higher brain centers; other nerve cells within the retina perform the first stages of analysis of the visual world.”

Paradigm shift

So the next paradigm shift is to stop talking about what the eye does and what the brain does.  The eye is part of the brain, so we should be speaking of what the eye does in relation to other areas of the brain.  We began to nudge this paradigm in 2004, in speaking of vision as a collaboration between the eyes and brain.  We wrote at that time, in a publication by the American Optometric Association, that signals travel back-and-forth between the eyes and the rest of the brain.  Were we to write the publication again today it would have been titled Vision: A Collaboration Between Eyes and the Rest of the Brain.

Through Gordon Dutton’s co-edited book I revisited two important references.  One is his classic 2003 article on cognitive vision.  The other is Donna Shaman’s 2009 manuscript on CVI.  They both come in Chapter 4 of the book, and I suspect I’ll have more to share as I read along in Starbucks tomorrow morning …

11 thoughts on “A Pair of Dimes Shift …

  1. Amanda has been quite interested in understanding CVI from an educational / rehabilitative perspective for many years. She was responsible for an amazing symposium in San Fransisco in 2005. The proceedings of the summit is available through AFB Press (as is the book you are currently reading). Amanda has lectured internationally on this topic and has collaborated with various optometrists and ophthalmologists.

    • Thanks, Barry. I am increasingly impressed with Lueck & Dutton and how they put all this together so well. My main concern is that this isn’t perceived as “oh, it’s really a brain problem, so it’s in the domain of education or neuropsych, and not optometry. Do you feel they appreciate the insights of developmental vision as pioneered by Optometry?

      • The short answer is that I think that they both do but have not had not had the opportunity for prolonged clinical collaboration.

    • What? Me, pessimistic? 😉 Good questions about whether he will publish in a peer reviewed Optometric journal. Perhaps Dr. Kran can float that idea by him. If so, I know the editor of a peer reviewed Optometric journal that would be pleased to receive his submission.

  2. This is terrific. I hope that the optometrists who still use the phrase “eye exercises” can stop the old habit and come to the understanding that we are changing the brain; Vision Therapy is much more descriptive since vision takes place in the brain. It is so ingrained in many of us ‘more seasoned’ ODs. When I made the decision to get serious about discontinuing that phrase, I told my young patients that if they used “eye exercises” I was going to charge them a dime, but if they heard their parents, our therapists, or me say it, they could charge us a **quarter**! Behavior Modification works…even on we “Old Dogs” especially when the young pups are on the prowl! 🙂

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