Talk:Behavioral optometry/Archive 1

Archive 1

Let's see this right

I was surprised that there hasn't been an article on this yet, so I thought I'd get the ball rolling.--Mallignamius 00:53, 6 July 2006 (UTC)

Any opinions regarding inclusion of a section/paragraph titled something along the lines of Criticism to address the issue of optometry being an evidence-based discipline yet rigorous, double-blind studies backing Behavioural Optometry being rare? There are many articles/sources that could be referenced for this. For example Sydney Morning Herald article or UK Optometry Today website. DW1979 (talk) 13:42, 21 June 2008 (UTC)

Data are important, and the time and money folks may be wasting on an unproven intervention are important also. If anyone has guidance it would be appreciated 70.182.52.50 (talk) 19:49, 15 September 2008 (UTC)Jason

Why so much weight to Baltimore study?

The majority of the article is now about this single study, published in 1946, referenced only by the study itself. Why? --Ronz (talk) 20:52, 21 December 2008 (UTC)

I've added two recent reviews (from 2000 and 2008). I'm surprised that the Jennings review hasn't been cited already, but since it is published in the Royal College of Optometrists professional journal and is not available without subscription, I guess that explains its absence... The Barrett review is, however, available online. Regarding the bias toward the Baltimore study, that was a controlled trial- not a review - and is therefore of greater importance. Perhaps other studies (available from the reference section of the Barrett review) could be cited? Famousdog (talk) 14:01, 15 April 2009 (UTC)

New York Times report

There is an extensive report in the New York Times on this subject: New York Times article I believe it would be very useful in expanding this article. ∴ Therefore cogito·sum 19:21, 10 March 2010 (UTC)

This Article Seems Biased

I don't know anything about this topic but I am disappointed that this article is so one sided. 74.104.104.178 (talk) 14:24, 17 January 2011 (UTC)

I, too, don't like the fact that the article is so one sided. I've added a tag to draw attention to our concerns. I'm an experienced Wikipedia editor with a small exposure to Behovioral optometry, but am not a subject matter expert. Maybe somebody will show up who can help improve the article. Lou Sander (talk) 15:55, 3 November 2011 (UTC)

The article is well sourced and the talk page doesn't exactly seem to be bursting over with complaints of bias... so why the banner tag? Could you perhaps tag problematic portions of the article to give us some idea of your objections? Famousdog (talk) 11:19, 4 November 2011 (UTC)

It's pretty negative overall, starting with 'claims to use a "holistic" approach'. The word "claims" and the quotes around "holistic" set a negative tone that is carried throughout the article. Lou Sander (talk) 02:24, 5 November 2011 (UTC)

Learning related vision problems

A new editor, Peaceful07 (talk · contribs), is adding two claims to the lede (introduction) of this article.

• "...the American Optometric Association have made a policy statement in favour of behavioural optometry" supported by this clinical practice guideline
• "It is also taught at post-graduate level in Australia at the University of New South Wales by Professor Edwin Howell" supported by this university web page.

Famousdog (talk · contribs) reverted this with the edit summary "That policy statement doesn't even mention behavioural optometry - it mentions vision therapy. You need to demonstrate that these are the same thing please."

My thoughts on it are this, for what they're worth. (I'm not an optometrist.) Behavioural psychology is about learning, so it's quite likely the cited guideline directly addresses the topic of this article. Assuming that's the case, the fact that the AOA has produced such a guideline probably belongs in the article, and possibly in the lede. But that fact should not be couched in terms or positioned in a manner designed to counter or debunk the point that the practice lacks strong evidence.

The article should probably outline where (what kinds of institutions etc.) the practice is taught, but that is unlikely to be appropriate for the lede. --Anthonyhcole (talk) 12:20, 22 June 2012 (UTC)

Hi Anthony, Am back, been busy preparing for new academic year. Ok, so I have email and phone contact for Professor Ed Howell in Australia, email contact for Professor Glen Steele at the Southern College of Optometry, Memphis, Tennessee and email contact for Professor Scott Cooper, Pacific University of Optometry, Forest Grove, Oregon. Although Dr Adrian Jennings is now retired I know people who know him and if you want a copy of his OPO journal article on Behavioural Optometry I am sure that I can get a copy. As regards Dr Brendan Barrett, I last emailed Brendan in the Summer so if you wanted an up to date contribution from him I am sure that he would oblige. Behavioural Optometry is taught as part of a MSc course at the School of Psychology, University of Birmingham there being a module on the effects on vision in acquired brain injury, the MSc being in Brain Injury Rehabilitation, the course leader being Dr Andrew Worthington from the School of Psychology. The issue you will have to contend with with the editing of this page is that in my opinion its remit impinges on that of Opthalmology in the US, Australia and somewhat in the UK. In the US and Australia, ophthalmologists are in competition with optometrists particularly in the treatment of amblyopia and strabismus. So they do not tend to indulge in dialogue instead doing their own research into their own methods without talking and discussing the methods used within Behavioural Optometry. I can only speak as regards the situation of eye care in the UK though could offer some thoughts on Australia having worked out there. In the UK the ophthalmologists perhaps tend to only look at research done by other ophthalmologists (well of the talks I have been to given by ophthalmologists they only tend to cite research done by other ophthalmologists though do not know if this is a representative sample). Orthoptists who work alongside ophthalmologists tend to only look at research done by other orthoptists and by ophthalmologists. Hospital optometrists tend to only look at research done by hospital optometrists, orthoptists and ophthalmologists so it tends to be a bit of a closed circle. So in editing this page if it is accessed by ophthalmologists and orthoptists they might wish to raise issue with points made. As someone working in academia, I am comfortable discussing the subject matter though as i say it depends where you wish to go with this. Apologies for taking so long to get back to you, it has always been in my thoughts, it is just there have been other issues which have been more pressing....peacePeaceful07 (talk) 12:29, 31 October 2012 (UTC)

Don't worry about the time, there's no deadline here, and conversations often range over years, as real life permits, and as our thinking changes in light of experience. I am aware of the suspicion or silo mentality that exists between optometry and ophthalmology - at least in Australia and the UK. I'll have a look and think about this and get back to you here. --Anthonyhcole (talk) 06:00, 3 November 2012 (UTC)

HI Anthony, I have emailed Dr Brendan Barrett at Bradford University Optometry School to arrange to talk to him sometime this week about jointly writing something more definitive on this page and of course having it written in conjunction with yourself. I have read up on the Wikipedia code of conduct and the idea of a conflict of interest so want to have something written which looks at both sides of the discussion with equal equanimity. Peace2.102.97.180 (talk) 21:19, 3 November 2012 (UTC)

Treatment of myopia

I'm wondering if maybe there should be an Alternative treatments for myopia article. While some behavioral optometrists do attempt to prevent or reverse nearsightedness, that is not the primary focus of the field. Yet a large chunk of this article is currently about that. There is the Bates method article, but not all such treatment is the Bates method (and defining exactly what the Bates method is and isn't has previously been a problem in that article.) The myopia article is already rather long, and lengthy discussions of non-mainstream treatment could cause WP:UNDUE problems there. PSWG1920 (talk) 04:58, 6 November 2013 (UTC)

recent reversions

The article has been pretty stable for over a year and had been looked at by several editors including known skeptics. The material in the Research section is well-sourced, relevant and balanced. I cannot make any sense of Jytdog's summary "unsourced per WP:VERIFY and otherwise violates WP:PSCI". On the other hand the newly introduced source by Steven Novella is unacceptable as WP:RS. It is an unrefereed blog, and mainly a personal attack against Charlene Werner. The new section Techniques does not serve as a statement of BO techniques; the ten points were introduced by Brendan Barrett as headings for his review; they weren't intended to summarise the discipline and just listing them without further detail gives little or no value. The are deficencies in the article as it was and no-one would object to a measured attampt to rectify them, but mass deletion can only lead to the WP:BATTLEFIELD mentatlity which seems to be threatened. SamuelTheGhost (talk) 17:24, 28 March 2015 (UTC)

why are you restoring unsourced content that violates WP:VERIFY? Let's just start there. Jytdog (talk) 17:28, 28 March 2015 (UTC)

Which content are you talking about? I've restored the whole article as it was. There may be dodgy bits in there whose deletion I wouldn't object to. SamuelTheGhost (talk) 17:46, 28 March 2015 (UTC)

So why are you restoring possibly "dodgy bits" into article space? (Not to mention health material sourced to non-WP:MEDRS sources and fringe special pleading!) Alexbrn (talk) 17:58, 28 March 2015 (UTC)

As I said, I restored the whole article as it was. There are parts of it that I wrote, and I'm content with them, and parts that I didn't, but left as they were out of respect to other editors. It really would help if either of you would spell out which bits you're objecting to. SamuelTheGhost (talk) 18:15, 28 March 2015 (UTC)

That is not acceptable. Edits were piecemeal; if you object to one or more of them, please do so. But you mass reversion restored nonviable material. Jytdog (talk) 18:21, 28 March 2015 (UTC)

Please don't just "restore the article" unless it improves it. We have no need to respect other editors' work if that work ran counter to the aims of the Project ... and this article was rather sub-par. I left fairly detailed edit summaries for all the changes I made. Alexbrn (talk) 18:25, 28 March 2015 (UTC)

I've made some changes, but Novella is still there though not valid as a source and the lead is still ludicrously POV. SamuelTheGhost (talk) 19:04, 28 March 2015 (UTC)

Novella is pretty useful by WP:PARITY. I'm not 100% sure he's indispensible, but a big improvement on the fringe-fest we had before! Alexbrn (talk) 20:18, 28 March 2015 (UTC)

Novella's ScienceBasedMedicine is recently taken to task HERE. Lou Sander (talk) 02:38, 26 April 2015 (UTC)

A kind of validation for SBM, considering Attkisson's reputation[1] on medical topics. Alexbrn (talk) 16:09, 26 April 2015 (UTC)

further reversion

I re-deleted the statement in the lead "The ideas behind behavioral optometry lack scientific plausibility and most research in the field is of low quality; it is therefore not seen as a recommendable treatment for any condition." which had been sourced to Novella and Barret. As I pointed out above, Novella is not a WP:RS. The claim that he is allowed by WP:PARITY does not hold water since t is based on an arbitrary assumption that ths topic should be treated as fringe, and in fact enough WP:RS do exist for this subject. As for Barrett, he is s good source, and in his paper lists three areas where "the available evidence is consistent with claims made by behavioural optometrists" so to cite him as supporting the view that it is "not seen as a recommendable treatment for any condition" is just dishonest. SamuelTheGhost (talk) 16:52, 25 April 2015 (UTC)

WP:FRINGE applies because this is a medical offering with no respectable support. Hence WP:PARITY applies too and Novella is an excellent source. Alexbrn (talk) 17:08, 25 April 2015 (UTC)

Alexbrn is correct, yes. Jytdog (talk)

Novella's blog post should only be cited for his own opinion, if and when his opinion is sufficiently important. Any sweeping statement about behavioral optometry should be based only on the best sources. If we didn't have a better source, it might be a different story, but we do. PSWG1920 (talk) 18:46, 25 April 2015 (UTC)

Let's look at some of what Novella actually says about Behavioural Optomery, ignoring the rest of his targets:

• "There is a kernel of legitimacy (perhaps) to some of what they do ..."
• "There also appears to be a spectrum, ... and I’m sure those behavioral optometrists who try to be evidence-based may take exception to being lumped in ..."
• "The one condition that seems the most plausible and is most accepted is called convergence insufficiency"
• and so on. Novella's blog isn't written in the way one would expect of an academic paper, and isn't WP:RS, but the use which Alexbrn has been making of it contains no hint of even this balancing material; rather it piles bias on bias. If editors cannot make fair use even of their own sources, it makes co-operation with them very difficult. SamuelTheGhost (talk) 22:29, 25 April 2015 (UTC)

Good points. Since we know that some aspects of behavioral optometry are agreed to be legitimate, the current intro is almost a libel on behavioral optometrists, and thus perhaps a BLP violation. I would not rely on the 3rr exemption for BLP in this case, but other than that we can insist on changing this. PSWG1920 (talk) 01:01, 26 April 2015 (UTC)

The "spectrum" is addressed in our article. You haven't addressed the point that Novella is usable here because this is a WP:FRINGE topic. It makes a useful supplement to Barrett precisely because academic sources don't generally dwell on the fringier aspects of fringe therapies - we use our WP:PARITY sources to achieve a fuller exposition. Alexbrn (talk) 04:15, 26 April 2015 (UTC)

The intro needs to be changed for sure. At this point it does not even accurately summarize the article. How Novella should be treated is another question, which could go around in circles. I would suggest that if and when we cite his blog post, we qualify it as his opinion. PSWG1920 (talk) 05:14, 26 April 2015 (UTC)

The lede is fine. Science-Based Medicine is a very good source for WP:FRINGE medical topics. Is there any reason to doubt it here? If not we can simply assert the information it gives us. Alexbrn (talk) 05:24, 26 April 2015 (UTC)

The current lede is not an accurate summary of the article or the sources, which make clear that some aspects of behavioral optometry are seen as having credibility. Someone who reads on will see that, but the lede is supposed to stand alone as a summary. Its current wording borders on a BLP violation, due to what it implies about behavioral optometrists. PSWG1920 (talk) 05:05, 27 April 2015 (UTC)

Don't be silly with the WP:CRYBLP. The source(s) are well summarized. The fact that some of the approaches might have some justification for continued research in no way validates this offering. As Barrett writes: "the continued absence of rigorous scientific evidence to support behavioural management approaches, and the paucity of controlled trials in particular, represents a major challenge to the credibility of the theory and practice of behavioural optometry." (my bold) If people are selling therapy that isn't backed by good evidence, it's no wonder this area is on Quackwatch's radar. Alexbrn (talk) 05:51, 27 April 2015 (UTC)

The lede looks much better now. I still take issue with the statement that "behavioral optometry is therefore seen as a field that lacks credibility." Regular optometrists refer patients to behavioral optometrists for some issues (I have confirmed this with optometrists on both sides), so it seems unfair to say that behavioral optometry as a field is seen as lacking credibility. Barrett himself does not quite say it that way; his summation appears to be more nuanced. PSWG1920 (talk) 18:12, 28 April 2015 (UTC)

I'm not sure about this phrasing: "Many of the ideas associated with behavioral optometry are lacking in scientific plausibility." Such language only appears in the Novella blog, which is at least disputed as a reliable source. Perhaps we could just say that many of these ideas lack a clear scientific basis, or something like that. PSWG1920 (talk) 23:41, 1 May 2015 (UTC)

I agree. Go for it. Also, the article seems to rely on what people other than Behavioral optometrists say are the beliefs and practices of Behavioral optometrists. Lou Sander (talk) 00:13, 2 May 2015 (UTC)

Incoherence

unproductive, nonspecific, mostly discussion of contribs not content Jytdog (talk) 16:34, 26 April 2015 (UTC)
The following discussion has been closed. Please do not modify it.
This article has a lot of it. Maybe someone could describe the field, in addition to saying that it isn't any good. See Chiropractic. Lou Sander (talk) 18:53, 25 April 2015 (UTC) WP:SOFIXIT - if you can find reasonable WP:RS and avoid giving undue weight to fringe notions. Alexbrn (talk) 05:26, 26 April 2015 (UTC) Much of the incoherence seems to stem from your edits. IMHO if you would withdraw for a while, the article would improve. (See for example your recent "trimming" of pertinent See alsos.) Lou Sander (talk) 08:41, 26 April 2015 (UTC) Says the editor who linked to something by Sharyl Attkisson! I think at least some degree of competence around fringe topics is probably helpful here. Alexbrn (talk) 16:04, 26 April 2015 (UTC)

Regarding competence about fringe topics, we are all wise to review the essentials of the subject:

This seems to be an article about a possibly fringe idea that IMHO meets the test of notability. A longer discussion of these matters is HERE. Regarding incoherence, this article IMHO badly misses the mark for good article criteria, particularly the criteria about Well-written, Broad in its coverage, and Neutral. Lou Sander (talk) 01:48, 27 April 2015 (UTC)

additional sources

I don't have time to dig into these now, but wanted to offer some reviews as recent as the one currently cited...

• PMID 21412896 (2011 cochrane review on Non-surgical interventions for convergence insufficiency)
• PMID 25051925 (2014 cochrane review on Interventions for strabismic amblyopia)
• PMID 24852157 (2014 review of Convergence Insufficiency and Vision Therapy) Jytdog (talk) 16:32, 26 April 2015 (UTC)

They are certainly reliable sources, and they seem to touch on some aspects of Behavioral optometry, though they do not mention it by name. For a description of B.O. by apparently legitimate professional societies (regardless of the scientifically proven or unproven nature of B.O.'s claims), we have THIS, and THIS, and THIS. For an organization of parents of children either benefited or hoodwinked by Behavioral optometry, we have THIS. These seven references, maybe augmented by others and handled by editors determined to write a neutral article, might allow an improvement in the B.O. article. Lou Sander (talk) 02:04, 27 April 2015 (UTC)

really important to use independent sources especially on near-FRINGE stuff... Jytdog (talk) 02:24, 27 April 2015 (UTC)

Even more important to maintain a neutral point of view in the article:

The NPOV link is to a policy:

The "independent" link is to an essay:

Lou Sander (talk) 12:40, 27 April 2015 (UTC)

WP:PSCI and WP:GEVAL and parts of NPOV. it is not uncommon for people to use non-independent sources to give false validity and UNDUE weight to FRINGE views. FRINGE is the guideline that fleshes out PSCI and GEVAL. There are some aspects of BO that seem to have the backing of evidence; some that are FRINGEy. That is what the article needs to say. right? Jytdog (talk) 13:21, 27 April 2015 (UTC)

No, not right. Behavioural Optomerty is based on the reasonable belief that human visual competence is at least to some extent, and at least in some respects, malleable. Its practitioners have developed some techniques intended to iimprove people's vision. The theoretical base for what they are doing is weak, but not unreasonable. There have been controlled experiments (such that in Baltimore whose description Alexbrn has repeatedly deleted from the article), which show limited successes but no big breakthrough. The article should say all that, in that tone of voice.

There is no reason to keep repeating the "fringe" mantra. Specific fringe policies like WP:PARITY are approppriate when used aganst ideas that are so certainly false that conventional science doesn't waste its time on disproving them, but that clearly does not apply in this case. SamuelTheGhost (talk) 17:42, 28 April 2015 (UTC)

Well said. There are legitimate professional societies in the U.S., U.K., Australia and New Zealand, devoted to the practice of Behavioral optometry. These are not fringe people, and what they do is not fringe medicine. On the other hand, there have historically been unfounded claims, made by long-discredited people, that some of their B.O.-like practices can eliminate the need for corrective lenses, cure learning disabilities, etc. The latter "curing" is easily confused with the more reasonable claim that what appear to be learning disabilities are sometimes actually "seeing" problems. It would be good if this article could say those things in a neutral way. Lou Sander (talk) 18:00, 28 April 2015 (UTC)

Oh it's fringe all right. As our good sources says it's largely unevidenced and anybody selling such unevidenced services (to treat autism maybe?) will be engaging in quintessential quackery. The very definition of the field is that it encompasses what real optometrists don't do! Anyway, if we stick to the good sources all will come good. Alexbrn (talk) 18:04, 28 April 2015 (UTC)

Please give us a little more insight into your understanding of the "very definition of the field". Lou Sander (talk) 18:09, 28 April 2015 (UTC)

It's not for me to understand, but to relay the views of experts who do. As Barrett writes: "In short, behavioural optometrists believe that optometrists can influence the visual process in ways that are not taught as part of traditional UK optometric education programmes". by that definition, this is an offering outside mainstream optometry. Alexbrn (talk) 18:36, 28 April 2015 (UTC)

Then Alex you will be pleased to see this article by Dr Kenneth Ciuffreda of New York State University which contradicts Barrett Loomis Ideology (talk) 06:48, 30 July 2016 (UTC)

What BO proponents believe?

In this letter to the Editor the correspondent writes

Behavioural optometry is concerned with visual dysfunction that proponents believe can exist despite the presence of good visual acuity, no refractive error or ocular disease, normal accommodation, normal binocular vision, and normal ocular motility. Examples of behavioural vision therapy tasks include hand-eye co-ordination activities, coloured overlay lenses, trampolines, or balance boards.

and cites (for the first sentence) a textbook to which I do not have access. Has anybody here got access? This would be the kind of independent contextualizing background information which would help this article. Alexbrn (talk) 06:10, 27 April 2015 (UTC)

I have a limited special access to libraries, and am willing to put forth effort to get my hands on this book and the others mentioned on the cited page. They are expensive books, and libraries may charge a fee to provide them. I have a concern that my effort and expense might be wasted when editors attack this material as unreliable, or provided by practitioners and therefore suspect, or from Occupational therapy and therefore unrelated to Behavioral optometry, or seek to introduce additional "quackery" articles to "balance" what is said in them. My concern is based on past experiences with otherwise competent editors who are fanatic about their causes. Lou Sander (talk) 13:08, 27 April 2015 (UTC)

Best to WP:FOC as you're talking a lot about contributors. Getting access to sources would be great. I don't see what the problem here is: we have review articles, medical textbooks, and independent commentary via WP:PARITY -- and enough of it to build a neutral article. I can get access to most journal articles and some reference books. Alexbrn (talk) 13:35, 27 April 2015 (UTC)

The problem is clear, and getting clearer every day. Lou Sander (talk) 21:39, 27 April 2015 (UTC)

The textbook referred to above is readly available for purchase second-hand from abebooks. SamuelTheGhost (talk) 22:13, 27 April 2015 (UTC)

Good get! The previous edition is inexpensive, but the current one isn't. Given current conditions, it's probably not worth getting either one. Lou Sander (talk) 22:49, 27 April 2015 (UTC)

It is definitely worth looking at this, but the latest edition should be used (in case it has been updated). Alexbrn (talk) 04:48, 28 April 2015 (UTC)