Answers to Dr. Kedzia's five questions: an American perspective

There are a number of good examples of how optometry has made a unique contribution to science. Contributions which have since been accepted by all of science. I will spend a great deal of time on Friday, describing the contributions of Dr AM. Skeffington. I will not dwell further on him other than to say that I tmst you will be here to see how the thoughtsof Dr Skeffington, 50 years ago, have, in light of new technology, been shown to be correct. Let us however digress and speak of the contributions of Glen Fry and Henry Hofsteuer. These two men are given credit for developing a method of mathematically describing the interaction of convergence and accommodation, first described by Maddox at the turn of this century. They were able to reduce the measurements of accommodation and convergence into a graphical representation and from there to develop mathematical models to describe the interaction of these two different aspects of vision. From this graphical analysis the understanding of the Accommodative Convergence to Accommodation relationship was described. This concept is used, I think, by all persons directly or indirectly who measure vision today. One should not also forget the work of Schor and Ciuffreda, clearly delineated in their landmark text book, VERGENCE EYE MOVEMENTS. These two men, while working at the college of optometry at the University of California in Berkeley have done much work in describing, further developing and then experimentally verifying interactions of convergence and accommodation in terms of mathematical models. These models predict more accurately the interactions of the different aspects of both convergence and accommodation. Can one forget the recently published work by Hung and Smith on the development of refractive errors in the young? Models which were developed years ago, by Harmon and Skeffington among others, which predicted that when an individual was placed in a stressful situation, the person would adapt to grow along the lines of stress to reduce that stress. Now, years after these optometric leaders proposed this model, Hung, Smith and others working at the University of Houston College of Optometry have published in the prestigious journal ,,Nature" the results of their treatment of young primates with spectacle lenses to change the actual growth ofthe eye. Or, can one forget the work of Drs. Held, Gwiazda, Cruz and Thorn at the New England College of Optometry where they have been systematically following the visual and refractive status of infants into adulthood. Dr Held told me in Atlanta last October, that they now have the children of the first subjects in their study. Their results are verifying to a great extent, the visual development profiles first projected by Gesell, Getman, Streff and Apell. I could continue for hours and will on Friday, describe partially the model of A.M. Skeffington, who proposed his dynamic model of the interaction of the body with the eyes and brain in the 1930's, yet, in light of improved technology, this model has been shown to be essentially true. I believe that a unique theory and theories of optometry does exist. Optometry is unique in that it is a neighbor to, but not part of psychology, medicine, education, etc. It is a different discipline, one not confined to the concept that something must be diseased, but rather that a normal visual system can be modified and improved to function more effectively. As a gymnast can benefit from better equipment, so can the visual system, depending upon the task it is asked to do, improve its behavior through specially designed lenses and prisms. Just as an Olympic gymnast requires a coach (why should they require a coach, they are already the best their nation has to offer-they are well past normal) then the visual system can be improved with proper coaching, an optometric discipline known as visual training. Not only, to make vision normal but to also stretch the envelope of human potential. The use of lenses and prisms for the task facing the individual and the coaching of the visual system to strive for perfection of performance is a much different model from other disciplines which generally considers restoring some one to a position of normalcy. Optometry's unique model is that we do not work with the ill, per se, but with the healthy; to make the healthy, all they can be.