What is Behavioural Optometry?

Defining Behavioural Optometry involves understanding VISION and how it is different from EYESIGHT.

Traditional optometry is more involved with EYESIGHT whilst Behavioural Optometry is more interested in VISION.  All patients will benefit from the more holistic approach, but it is especially suited to those with eye motor control problems, lazy eyes, developmental delays, neurological damage or learning delays.

Although the majority of Behavioural Optometrists’ patients are children, Behavioural Optometry may be suitable for patients of any age if their condition is likely to respond to this treatment.


Eyesight essentially refers to the physical attributes and performance of the many organic components involved in the visual system.  Thus there is a high emphasis on structure, pathology and measurements of function of these components.


6/6 vision is a commonly quoted measure of normal VISION, yet it simply describes the sensitivity of the eye to see fine detail in the distance.  This is certainly an important measurement but having 20/20 vision does not guarantee that a person can read.  Reading requires good VISION.

In most instances vision uses eyesight as its foundation.  So understanding all aspects of traditional optometry is extremely important to a Behavioural Optometrist.  Unlike eyesight, which is strongly related to the performance of components in the visual pathway, vision is a thought process.  Vision combines information from many sensory systems to create a perception of reality.

Vision uses information from all the senses, including hearing, smell, touch and even the taste sense, which is then combined with information provided via eyesight.  All this is in turn processed, linked to memory and an image of the world or object is created.  This overlay of the senses is evident in the Thalamus, a key component of the brain, which regulates which sensory modality is being accessed at any point.

Vision is learned, so understanding the normal developmental pathway of an infant, through to child to teenager to adult is extremely important to Behavioural Optometry.  A child with limited environmental experiences is more likely to show abnormal development of vision.  Likewise a child with deficiencies in the physical structures that provide the initial sensory information is also more likely to show abnormal development of vision.

A child with a vision problem may experience a learning delay that is not necessarily related to intelligence. Intervening to provide the stimulation required to encourage more normal development of vision is one of the goals of Behavioural Optometry.

Many adults who once had normal vision may experience poor vision after sustaining head injuries, strokes, car accidents and neurological disease (such as Multiple Sclerosis) as brain function is often impacted.  Behavioural Optometry aims to understand the role of brain function in vision, thus providing opportunities to help these people.

When carrying out an assessment we look at convergence, tracking, scanning and focussing linking up to depth perception as all of these areas can affect concentration and visual comfort.

Visual processing or understanding of visual concepts are also looked at.

If issues are found in the above areas we treat them with lenses (single vision and multifocals), prisms, coloured lenses and vision therapy with both in-house and home programmes an option.

The author, David Evian O.D., is a Behavioural & Paediatric Optometrist at Evian Eye Care, where he and his optometrist daughter, Sindy, have been servicing the St Leonards community for 60 years. The family run practice offers the very best in eye care with a special interest in children’s vision and behavioural optometry.