Behavioral optometry

The Funktionaloptometrie deals with " malfunctions that occur in healthy eyes because of an incorrect or visual behavior of a faulty vision development and can lead to problems of visual perception " (as defined in WVAO, Scientific Association for Ophthalmic optics and optometry ). The Funktionaloptometrie is integrated as a sub-discipline in the faculties of the eye optics and optometry and sees itself as a specialized science. In the USA, the country of origin of Funktionaloptometrie, the term is used synonymously Verhaltensoptometrie.

Theoretical foundations

The quality of the visual stimulus perception and processing ( vision) can be detected only by the incomplete assessment of individual characteristics (eg, visual acuity ), the performance of the visual system can be also affected by environment, individual behavior and learned response patterns.

The Funktionaloptometrie assumes that with increasing distance our way of life from natural sources, ie from the continuity in our history, our perception would work less and less clear in the usual way. The development of the perception of the child in a big city apartment is so fundamentally different than it was a few generations ago that many stages of development no longer taking place in the usual way.

In individual cases, the coincidence of a number of negative factors lead to problems of visual perception. These include efforts complaints ( asthenopia ), headache, red eyes, reading and spelling weaknesses (also known as visual elements in dyslexia ), fatigue at the workstation, , and more. From these assumptions and findings out to the Funktionaloptometrie ( Verhaltensoptometrie ) has developed. She is in the U.S. part of the university education for optometrist.

Procedure

The Funktionaloptometrie assumes that visual problems can not always be achieved by an intervention at a single location (eg, through the regulation of spectacles ), but it should rather be a total viewing habits changed (such as ergonomics, lighting, workflow, etc. ).

The core of the Funktionaloptometrie the Visual is analysis, which with the help of the medical history (anamnesis), numerous function tests ( eg quality of pursuit movements, saccades, Konvergenznahpunkt, van Orden - star, etc. ) and a long series of measurements (so-called 21 -point measurement - OEP) would achieve a comprehensive overview of the visual situation of the client. It may be extracted, the points at which the visual system ineffective work and whether it can optionally be trained (Visual Training).

Training and certification

The term " Funktionaloptometrist " is protected by law, neither by a state recognition nor by professional codes, like for example "Eye Trainer". In this respect, any person may, theoretically described as Funktionaloptometrist without verification of his knowledge, or his educational background. One reason for this lies in the fact that it is politically profession currently is no agreement on the extent and content of Funktionaloptometrie within the training as an optician or optometrist. In principle, any person who has passed an examination as a master opticians in Germany to the profession considers entitled to perform ophthalmic services that are associated with the Funktionaloptometrie. A further training or education in Funktionaloptometrie or a certification for Funktionaloptometristen is not offered by the central education center of the Central Association of optician Germany ( ZVA ) and is not part of the curriculum for optometrists. Such seminars are therefore conducted in private institutions or corporations over an entire seminar period of about 18-20 days. A unified approach to training, there is not yet, and it is noted that " the line between mediation neutral technical information and " company-related event " is not always sharply drawn ."

A form of training and the attainment of an appropriate certificate is regulated in Germany by the Scientific Association for Ophthalmic Optics and Optometry ( WVAO ), requires a master craftsman examination in opticians craft or adequate training and includes the following:

• Participation in the WVAO basic course, and other advanced courses consisting of Visual Analysis - 21 points - OEP ( Optometric Extension Program )
• Functional tests
• LRS ( reading and spelling weakness )
• Myopia
• General Skills
• Amblyopia

After successfully passing an exam WVAO the certificate is " Approved Consultant for Funktionaloptometrie " granted. The certificate is renewed annually through training. After a period of two years without training, the exam must be taken again.

Distribution in Germany

The Funktionaloptometrie since around 1992 in Germany part ophthalmic activities. However, it is only offered by some 5 % of practicing optometrist. A rising trend of recent years is explained by the increasing establishment of Funktionaloptometrie as a business branch of Optometrists. In 2008, about 115 Funktionaloptometristen with WVAO certificate were listed in the WVAO. The largest area of ​​application lies after a survey of optometrists in the group of children. More attention is given to the observation of increased visual stress in the workplace, as well as a visual performance boost in sporting activities.

Background and significance

Approach and conclusions of the Funktionaloptometrie be viewed very critically in Germany. It is stated that there has been a lack in Germany of a clear definition and description funktionaloptometrischer content and its placement on a scientific and subject-specific basis. The via the ophthalmic aspects beyond issues of Funktionaloptometrie are often components of the ophthalmic specialty disciplines of Strabismus and Neuro-ophthalmology, with which the power spectrum and the science-based vocational training to legally regulated basis by orthoptists and ophthalmologists is already covered high quality and competent. A relevant supply gap and a resulting increased demand is characterized, at least in Germany and German-speaking countries, has not yet appeared.

On the part of the professional associations of ophthalmologists and orthoptists ( Professional Association of German Ophthalmologists and professional association of orthoptists Germany ) is conjectured, that the power spectrum of eye care professionals due to rising competitive pressure to medical and therapeutic activities to be expanded. In addition, one of the training content and duration is expected correspondingly low level of quality, which could adversely affect health care. The risk, thereby violating the Heilpraktikergesetz would encounter so that you can " disease" called " malfunction " and " therapies " are replaced by "training" in order to allow the Funktionaloptometristen access to therapeutic action.

The Funktionaloptometrie comes in his own words only "healthy" eyes on the application. In Germany it is according to professional codes reserved exclusively for doctors to assess whether organ systems are healthy at patient's complaints or not. On the part of Funktionaloptometristen is so far no uniform and binding process on the medical evidence of an intact health of their clients established which could assure them, if necessary, that their activities would be performed on healthy eyes healthy with binocular vision. Moreover, the allegation is fundamentally unclear how the resource Funktionaloptometristen supposedly diagnostic and therapeutic medical treatment services, the doctors and reserved them are even prohibited by the law as a medical practitioner requiring a permit practice of medicine.

Also, within the occupational group of opticians itself is the subject of " Funktionaloptometrie " controversial. This is what professional linguists certain aspects of Funktionaloptometrie as a pseudoscience with esoteric methods of treatment. They fear also about the positive appearance of optometry in public. In addition, disputes with the professional groups of ophthalmologists and orthoptists be expected because of the activities Funktionaloptometrie would clearly exceed the limits for diagnostic and therapeutic ophthalmic already. Furthermore, one suspects a lack of competence and qualifications regarding the necessary scientific and medical principles and skills.

Be viewed positively by the interviewed opticians optimal care of the clients and helping with visual difficulties. In addition, the assurance of the profession by strengthening the competencies and expertise, as well as a delineation to the eye doctor plays a role in the positive consideration of Funktionaloptometrie. In addition, the further away from the pure craft and towards an expansion of their horizons with a definition to the standard opticians is considered positive.

A direct transfer of the U.S. U.S. approach to the German situation is not possible for many reasons. In addition to some fundamentally different practice areas of German and U.S. American optometrists also the underlying educational content, professional codes and legal bases differ significantly from each other. It is not yet clear whether such a development in Germany is supported by the existing legal and professional codes.