Talk:Vision therapy/Archive 3

Archive 1

Archive 2

Archive 3

New archive

I've just archived a lot of material from 2010 onward. Lou Sander (talk) 19:42, 7 April 2015 (UTC)

Result of merge discussion

It doesn't seem that there's a lot of strong opinion about merging. There seems to be some sort of consensus, or at least an opinion, that neither article is very strong. My own thinking is that both articles are like newborn mammals. Neither one is a credit to Wikipedia, its editors, or the subjects under discussion.

I think it would be an improvement if all the material in Vision therapy that discusses Behavioural visual therapy would be moved to the Behavioral optometry article, along with the behavioral optometry stuff in Vision therapy's Controversy section and the "Other forms" paragraph that precedes it. It could be replaced with a sentence or two about Behavioral optometry, with links to that article. That would leave Vision therapy with mostly non-controversial content. That content and its presentation could then be improved, without editors feeling the need to include large amounts of negative material. Lou Sander (talk) 15:32, 10 April 2015 (UTC)

A question for clarification: I suppose that before (or right after) doing so you would adapt the lead of the "Behavioral optometry" article? This is because that article's lead currently reads "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", meaning that any passages that would be moved to that article would thereby be entirely discredited, simply by being placed under that lead. (Unless of course you would move only extremely controversial material to there, but I think that is not your intention either.) For that reason, it would be helpful to know the general lines of that article's (new) lead, if there's anything you could say on this. --Chris Howard (talk) 15:51, 10 April 2015 (UTC)

It should be noticed that the current state of Behavioral optometry arises from major chnges made very recently. It might be easier to go back to its state in November and start from there. SamuelTheGhost (talk) 16:46, 10 April 2015 (UTC)

I would certainly be in favor of that. Without having looked closely at every point, I have to say that the article in November was a much better article than the one right now. Lou Sander (talk) 21:51, 10 April 2015 (UTC)

Using the November article as a starting point (text on left of 'major changes' page) I will look through what has been written and suggest changes/amendments having noted in previous discussions moderators have asked for citations which I will source. I will get back to you all soon. Have a good weekend.Peaceful07 (talk) 06:56, 11 April 2015 (UTC)

I have read both articles and the history of the extensive edits and discussions. The articles do not seem to be informative in explaining Behavioral Optometry or Vision therapy and what either involves compared to say the Wikipedia articles on Orthokeratology and Refractive surgery. A lay person or professional reading the articles would in my opinion not gain any insight into either subject. I would want to start by rewriting the vision therapy article. As regards this, I do not see the relevance of the MKH (Polatest) method to the article as this is only practiced in Germany, Austria and Switzerland to my knowledge and by optometrists and ophthalmologists and is not in my opinion vision therapy. A separate article on the Polatest and the work of Haase might be merited. The mention of work with myopia and mention of the Bates method does not seem relevant either as I would not term this as vision therapy. So I would suggest starting with a rewrite of the vision therapy article along these lines. Any thoughts?Peaceful07 (talk) 06:11, 12 April 2015 (UTC)

Despite having contributed the section on MKH (link) I agree that it is rather like a white elephant in the article, at least in the sense that it is overly long. Concerning your suggestion, I am not convinced that the MKH and/or the Polatest are sufficiently relevant to merit an article on their own. I would suggest to create a new article on Haase and move the text to there (I could take over that part of the work). In my view his MKL method would still be worth a one-sentence mention in the context of the vision therapy article, for example in a section on other approaches practiced worldwide, simply because its advocates consider it a form of therapy and it does concern the vision system. Further thoughts on this? --Chris Howard (talk) 07:43, 12 April 2015 (UTC).

That sounds fine to me. I will get writing. I am going to confer with some colleagues who work in academia about this including Brendan Barrett. It may take a couple of weeks to complete the rewrite depending on how soon people get back to me. Peaceful07 (talk) 13:14, 12 April 2015 (UTC)

P.S.: I have done what I promised and have created the new article Hans-Joachim Haase (optician) and reduced the mention of the MKH method here to a single sentence. That should make the next steps easier. --Chris Howard (talk) 17:45, 12 April 2015 (UTC)thank you Chris.Peaceful07 (talk) 23:07, 12 April 2015 (UTC)

@Peaceful107: You seem to have good insight into the subject matter and how the article might be improved. At the same time, your Wikipedia editing skills seem to be extremely weak. Those skills are vitally important in editing articles, especially when the edits are extensive. I think we would all benefit if any writing you do were first done on a sub-page to your user page, where others could see them and comment on them. When you're ready to start, let us know on this page and we can show you how to proceed. Lou Sander (talk) 16:12, 12 April 2015 (UTC)

Lou, I agree entirely and did have a major concern in this respect. I was going to ask you where to put the copy once I had written it. Thank you for the advice. Will be in touch when I and my colleagues are happy with my copy.Peaceful07 (talk) 22:55, 12 April 2015 (UTC)

@Peaceful107: I think you might need some eye exercises, cuz you don't seem to see how to do basic stuff. :-) When posting a comment, please start on the line below the previous comment. It's a good idea to skip a line between them, too. If you start a paragraph with one or more colons, it will be indented one step for each colon you type. Once things get indented too far, you can start in at the left side again. To see what I mean, go into edit mode on this page and take a look at the last few posts in this series. If you can't see them too well, I've got a Marsden ball you can borrow. (Just kidding, of course!) ;-) Lou Sander (talk) 23:52, 12 April 2015 (UTC)

Thanks, that did make me smile and again thank you for the advice:-)Peaceful07 (talk) 04:27, 13 April 2015 (UTC)

Lou, on the subject of advice, if you are using a computer late at night, you might want to consider the use of the F.lux programme https://justgetflux.com/ Peaceful07 (talk) 05:06, 13 April 2015 (UTC)

Interesting! Lou Sander (talk) 15:14, 13 April 2015 (UTC)

Hi Lou and other mods, I decided initially to look at your citations as regards vision therapy not being effective rather than rewriting the page starting with the German ones. The evidence of these citations did not fit in with the accepted theory and indeed the results of the research experiments you have cited for the Zeiss Polatest/MKH method do not concur with the associated text. I conferred with Volkhard Schroth who had co-authored one of the papers who I have been in contact with in the past and he confirmed my thoughts as well as saying the results of his research project had been misconstrued. I will continue to work through the other citations and tell you when I have completed assessing all of them for experimental rigour. You are welcome to keep the german citations for the moment. Let me know where you would like me to post proof of why certain citations are not correct when I have worked my way through all the relevant citations.Peaceful07 (talk) 16:49, 23 April 2015 (UTC)

Hey guys, just read an article on the integrity of Wikipedia mods on the Guardian website. Part of the reason I am so tired is that I have actually disproved all of your citations apart from the Jennings and Barrett ones but did not want to say, a bit of a delaying tactic on my part, well 10mins for what it matters. I reckon there is a means of disproving the Jennings and Barrett papers as well in theory though it does not count until it is submitted as a paper so they stay regardless. There the truth can be liberating. Thank goodness for Grant Shapps....who would ever think that sentence would ever be written. I was concerned about your integrity until I read the Guardian article. Once I am wider awake I will clear up the reasoning to put it into vernacular rather than formal language so that you as mods can understand my reasoning better I can send it to you posting it where appropriate. That will probably be Saturday now. I am also tired because of the surprise that anybody, not you in particular, scientific colleagues will not represent their data correctly (not Jennings or Barrett as Adrian taught me and discussed his paper with me when completing it and Brendan emails me for information about areas of behavioral optometry he has been asked about as an academic....they are both solid academic types.

I will write new copy and cite as required.Peaceful07 (talk) 21:35, 28 April 2015 (UTC)

@Peaceful07: The first thing you need to do is to set up a User page for yourself. It's not hard. The page doesn't have to say much at all. Then set up a sub-page under that user page. Call it something like User:Peaceful07/Vision therapy. Then use it to post the corrections you'd like to see made to the Vision therapy article. I'd leave Behavioral optometry alone for a while, since it is controversial. Start with easy stuff about VT. Make sure that whatever you state is cited somewhere in a Reliable Source. Then post a notice here that your work is available on your user subpage, and provide a link to it. We can look at it and approve, or question, or whatever. Don't worry too much at this point about the folks who post bad information. Usually they will retreat in the face of well-sourced material. Lou Sander (talk) 22:25, 23 April 2015 (UTC)

Lou, I can now post a word document on my user page detailing how I have taken out all the citations on both the 'vision therapy' and 'behavioral optometry' Wikipedia pages. I can also take out the Jennings and Barrett citations though do not think this is the time to do it.

I will start writing a new page this weekendPeaceful07 (talk) 21:33, 28 April 2015 (UTC)

famous dog, How are you? Are you still in Norway? Interesting that you suggest a merge. I do not see any good reasons for this. It will make an already challenging subject more challenging for the layperson or associated health professional to understand. My expectations of Wikipedia is for easily read and accessible content. Your suggestion would in my opinion not be in accordance with such guidelines.Peaceful07 (talk) 00:03, 24 April 2015 (UTC)

@Peaceful07: Go to User:Lou Sander. In the left margin of the page, under Tools, you will see Email this user. Click it and follow the instructions. Your email will end up in my mailbox. Lou Sander (talk) 00:46, 24 April 2015 (UTC)

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Yogic eye exercises

Just dropping this here for consideration. Belteshazzar (talk) 05:47, 15 August 2020 (UTC)

First two sentences

Disclaimer: I work for a company that makes vision therapy products.

As a professional scientist in this field, I can see that the first two sentences are not sufficiently neutral. Here's the problem: Not all VT is alternative medicine, only some of it. Unfortunately, "vision therapy" is indeed an umbrella term. It includes nonstandard, ineffective treatments such as the Bates method for treating myopia. However, VT also includes standard treatments such as occlusion (eye patching) to treat suppression, and exercises to improve accommodative and vergence ranges. Some of the best optometry programs in the country, including UC Berkeley and SUNY College of Optometry, use these VT methods in their clinics and teach these methods to students.

Support in the literature for the use of VT for convergence insufficienty is rock solid. Twelve years ago Ref 1 (Barrett 2009) identified this as the one area he studied that had good emperical support. Several randomized clinical trials since then have confirmed its efficacy. This is a known fact now, not a claim.

I'm not a regular contributor to Wikipedia so I wanted to discuss this before making changes to the page.

Thanks, BTB (talk) 00:46, 2 September 2021 (UTC)

Article Bias

There appears to be a fairly biased viewpoint presented in this article. No studies supporting vision therapy or it's effects are cited. The first two sentences are a perfect example of this.

It would benefit the public and the reader to have a broad scope of research that both criticizes and supports vision therapy and to be aware of the political conflicts between optometry and ophthalmology. Almost all studies that are against vision therapy are from Ophthalmology and are often reviews and opinion pieces that are very selective in their cited works and 'interpretations'.

Anytime any of this research is added to the article, it seems to be immediately deleted.

Cmccrodan (talk) 19:57, 3 September 2021 (UTC)

A perfect example is the CITT study that is a double blind placebo controlled study showing that Vision therapy is effective treatment for convergence insufficiency.

Please note my original user was cmccrodan. I had to create a new account rather than re-naming. Snapdginger (talk) 02:03, 4 September 2021 (UTC)

@Snapdginger:, You need to read WP:FRINGE WP:NPOV and WP:CONSENSUS before you make any more edits to this article. Unilaterally changing text in an article that has a long-standing agreement of multiple editors (see the previous talk page archives) cannot be unilaterally overridden by one editor's decision.

The Manual of Style generally does not require citations for claims in the lead paragraph(s) as it summarizes information that is cited in the body. The body states: Based on assessments of claims and studies of published data, ophthalmologists claim that, except for the near point of convergence exercises, vision therapy lacks documented evidence of effectiveness. This is cited to Helveston, Eugene M (2005). "Visual Training: Current Status in Ophthalmology". American Journal of Ophthalmology. 140 (5): 903–10. See also Barrett, Brendan T (2009). "A critical evaluation of the evidence supporting the practice of behavioural vision therapy". Ophthalmic and Physiological Optics. 29 (1): 4–25. and Novella, Steven. "Vision Therapy Quackery". Science Based Medicine. sciencebasedmedicine.org. From these, it is clear that the mainstream opinion among relevant scholars is that, with very limited exceptions, vision therapy usually describes an alternative medical approach to vision problems. This is how the topic is described in the body and how it should remain described in the article body.

Lastly, concerning the point you made on my talk page about the Facebook posting, You also need to read the behavioral guidelines on WP:CANVASSING and making requested edits. I hope this is helpful information. Eggishorn (talk) (contrib) 15:19, 4 September 2021 (UTC)

Definitely helpful. Sorry for being such a noob. What’s the best way to get more information to multiple editors? Snapdginger (talk) 15:42, 4 September 2021 (UTC)

Never mind. It was in the information you posted. I’ll open up a discussion topic.

Thanks for your patience with me learning the ropes. Snapdginger (talk) 16:01, 4 September 2021 (UTC)

Proposal to improve article neutrality and give weight to all reliable sources

I propose that the page is edited to reflect the wiki neutral point of view criteria.

Background: Both optometry and ophthalmology are mainstream professions and widely accepted. Journals of both professions are peer reviewed and constitute reliable sources and mainstream literature. There is different theory between the two professions around the function of vision, which represents a lot of disagreement. Ophthalmology is not taught much about vision therapy apart from 'it's quackery' (two of my best friends are ophthalmologists).

Controversy: Articles supporting vision therapy primarily come from optometry, while articles discrediting it come primarily from ophthalmology. Many claims by vision therapy doctors are not supported by evidence. Eg: The diagnosis of a learning disability requires ruling out any eye tracking problems , so by pure logic any type of vision therapy cannot help a learning disability.

There is adequate evidence for vision therapy in convergence insufficiency and for visual rehabilitation after brain injury. Even a non-neutral angry article that declares it quackery admits this "Although there are areas where the available evidence is consistent with claims made by behavioural optometrists (most notably in relation to the treatment of convergence insufficiency, the use of yoked prisms in neurological patients, and in vision rehabilitation after brain disease/injury)"

In summary, the page needs to reflect the facts that there are studies supporting vision therapy by optometry (reliable sources), but ophthalmology's position is that it's largely unproven except for the areas aforementioned.

Disclaimer: I was educated in engineering, then optometry. I graduated thinking it was quackery until I realized that areas of it make sense and follow known physics and neurology, and are supported by evidence. I dislike misleading statements made by some of my peers (quackery), but do not want to see the baby thrown out with the bathwater. — Preceding unsigned comment added by Snapdginger (talk • contribs) 03:19, 21 October 2021 (UTC)

References

I don't know why you find a source "angry" (sorrowful might be it), but it does not say what you think it says. The proposal is largely WP:ADVOCACY and seeks to frame the push-back against quackery as a "turf war" in exactly the way the SBM source warns of. In general, source on altmed from altmed sources are unreliable: optometrists talking to themselves have lesser eight. For the use of prisms, there is more up-to-date secondary literature, pmid:31120142. Alexbrn (talk) 05:07, 21 October 2021 (UTC)

So a profession speaking to a profession has less weight? Who is the Audience for most papers and studies? Do most journals not publish for members of the profession? Snapdginger (talk) 13:21, 21 October 2021 (UTC)

It’s worth adding I’m a natural skeptic, including in my own field.

With the right framework and other editors I could help the article be more accurate in language and claims. This could be interpreted as ‘accurate’ meaning pro-vision therapy. That is not the intention. I mean accurate as in clarifying points that have been misinterpreted or taken out of context. Eg: the basis for vision therapy. Proposed reasons for yoked prism. Not to make claims that are unsupported, but to offer more information about the background for some claims in a neutral manner.

I realize I set off some alarms about advocacy because some of the first changes I wanted to make. Please don’t let that colour my ability to contribute in a meaningful way that will bring more knowledge on the topic to anyone who wants to read it on wiki. Snapdginger (talk) 13:55, 21 October 2021 (UTC)

By that argument you'd be citing homeopathic journals for homeopathy and its wonderous powers. It comes back to this being a fringe topic, apparently without recognition (other than scornful recognition) outside its own realm, except for one or two specific treatment sub-types. What independent recognition this therapy does get appears to be as a example of pseudoscience in scholarly texts examining that phenomenon. Alexbrn (talk) 14:46, 21 October 2021 (UTC)

Optometry is mainstream. Homeopathy is not. I assume you are familiar with the process of publishing papers in peer reviewed journals. How often do journals take articles that are outside of their scope? Your circular logic surrounding the SBM quote demonstrates your confirmation bias.Snapdginger (talk) 02:45, 22 October 2021 (UTC)

Making it personal is never a good idea on Wikipedia. Vision Therapy/Behavioral optometry is largely quackery/pseudoscience/fringe, per reliable sources (not by circular argument). That's just the reality Wikipedia needs to reflect, rather than try to change it. Alexbrn (talk) 03:51, 22 October 2021 (UTC)

Giving equal weight would result in WP:GEVAL (false balance). Not all sources are acceptable to support biomedical claims (WP:MEDRS). Journal quality varies and most papers are considered primary, but systematic reviews are better. Large official medical body statements are also good, —PaleoNeonate – 20:18, 23 October 2021 (UTC)

FT/N

I have posted about this article at WP:FT/N#Vision therapy. Alexbrn (talk) 07:26, 21 October 2021 (UTC)

Thanks for doing that. I believe that someone with more experience could be helpful in navigating this area. I realize I probably put you on the defensive with a few mistakes I made when new (namely editing the article without getting a consensus on the talk page). I’m appreciative of your guardianship, because I’m sure many truly pseudoscience topics take a lot to maintain due to advocacy edits. Snapdginger (talk) 13:38, 21 October 2021 (UTC)

• I've just noticed QuackWatch has some updated[1] (2018) content on this. It looks like the therapy has one legitimate sub-treatment (around convergence problems) but is mostly quackery aimed at desperate parents, promising to cure their children's learning problems by some mysterious process of eye training that mainstream medicine is ignorant of. A bit of Googling confirms this is the principal sales pitch (e.g. "children with poor vision skills may be bright — yet something is holding them back. They may work harder than their peers, yet still be unable to achieve the results they seek"[2] or "When vision problems go undetected, children almost invariably have trouble reading and doing their schoolwork. They often display fatigue, fidgeting, and frustration in the classroom - traits that can lead to a misdiagnosis of ADD, ADHD, dyslexia or other learning diablilities"[3]). Alexbrn (talk) 15:20, 21 October 2021 (UTC)

One of the symptoms of convergence insufficiency is difficulty sustaining focus on near tasks. https://www.mayoclinic.org/diseases-conditions/convergence-insufficiency/symptoms-causes/syc-20352735 Logically speaking, it’s worth ruling out if that is a difficulty. Claims that absolutely any trouble with focusing is related to the eyes is the part that is quackery. Does that type of logic make sense?

Look, we can serve the greater good of wiki and the public If you will take things into account that don’t support your current narrative. You continue to cherry pick literature to suit your POV. You are a reverse advocate. Staunchly entrenched in a single point of view with absolutely no willingness to have any sort of educated discourse. Never have I been so sad for wiki. Snapdginger (talk) 05:15, 22 October 2021 (UTC)

We follow sources and abide by policy. But with that tantrum, it's time to WP:DENY. Alexbrn (talk) 05:29, 22 October 2021 (UTC)

Terms need clarification

Almost no technical terms have been defined in this. In particular, it would be useful to define and explain the differences between:

• opthalmology, optometry, and orthoptics
  • orthoptics and orthoptic VT (I got the sense that orthoptics is probably the evidence-based use of VT from how the article is currently written)
  • optometry and behavioural optometry
    • behavioural optometry and behavioural VT
• strabismus and convergence insufficiency

Alternatively, if there is no difference between some of them, please make that clear and then also try to stick to only using one of them. I spent a lot of time trying to restructure the article but was unable to do much because these terms have been used in a very unclear way. --Xurizuri (talk) 11:25, 22 October 2021 (UTC)

It would be great if we could. My impression is the vocabulary has been shifting over the last twenty years and while it seems modern sources equate VT and BO, this wasn't always the case. I wonder if there's a source that specifically discusses the terminology. Alexbrn (talk) 11:31, 22 October 2021 (UTC)

Some redundancy

The Eye exercises and Techniques sections appear to repeat themselves, it would probably be possible to merge them in a single (more detailed if necessary) section... —PaleoNeonate – 19:15, 23 October 2021 (UTC)

Request for Comment on legitimacy

Vision Therapy is an umbrella term for many practices, some of them fraudulent, but many of them - based on my own and several family-members' experiences - not fraudulent. Going by the rest of the talk page, I am far from the only one who's upset that this whole entire field of medicine is being framed as a pseudoscience - but the fact that most of the existing sources are sneerish handwringing about the efficacy studies which have been done, makes it hard to actually edit the thing. People just revert it for "removing sourced content". I need help.2406:5A00:329C:4600:6496:382F:F297:11C5 (talk) 06:04, 6 February 2022 (UTC)

• (invited by the bot) It's a broad / vague term which probably covers both science-based and pseudoscientific (= falsely claims or implies to be science based) fields. The lead seems to be both badly written in that respect and also the lead is supposed to be a summary of / taken from what is in the article. But IMO you really need to first try opening a discussion on the talk page. And if you do move to an RFC, it needs to start with specific neutrally worded question. Of course you can follow it with your own weighing-in, including making the case for what you said. Sincerely, North8000 (talk) 14:33, 6 February 2022 (UTC)
• Why should I not pull the {{rfc}} tag again? The reasons I gave last time still hold, with the addition of the first entry at WP:RFCNOT, because of the final sentence I need help. --Redrose64 🌹 (talk) 21:27, 6 February 2022 (UTC)
• You may want to have even a single reliable source to back you up here, and ideally an actual reason why the current sources aren't reliable, or there's a snowball's chance in hell of those changes being made to the article. --Xurizuri (talk) 03:14, 9 February 2022 (UTC)
• The article has some solid sources. Per them, VT is mostly quackery except the convergence insufficiency stuff. Alexbrn (talk) 03:22, 9 February 2022 (UTC)
• (Summoned by bot) - pulled RFC, in line with the reasons given by Redrose BilledMammal (talk) 11:13, 11 February 2022 (UTC)

Merger proposal

I propose that Behavioral optometry be merged with this article, Vision therapy. There is considerable overlap in the content of the two articles. Also, while some areas of Vision therapy are non-controversial, others are very controversial, particularly those that fall under the rubric of Behavioral optometry. Having all this material in one article would facilitate fair and encyclopedic descriptions of the controversy and its boundaries, as well as of the non-controversial areas. Those descriptions, IMHO, are not well-handled at the moment.

Full disclosure: While twice in my life I have been helped greatly by vision therapy, I am very aware of the extravagant claims sometimes made for it, and of the wide opposition to those claims. I would welcome the challenge of working to improve a merged article. Lou Sander (talk) 19:42, 7 April 2015 (UTC)

Comment: At first glance, a merger would seem to make sense. Ceannlann gorm (talk) 21:44, 7 April 2015 (UTC)

Comment: I support this for the time being. The contents of Behavioral optometry, as it stands, are a good summary of the topic and can easily fit into a less-rambling version of Vision therapy. But a lot more can be said about behavioral optometry than we presently do, so at some point per summary style a more detailed stand-alone article on behavioral optometry could/should be created. --Anthonyhcole (talk · contribs · email) 01:45, 8 April 2015 (UTC)

Comment: Good idea! There's a lot to be said about both these topics. If there is consensus, we could try to say it all, in a coordinated, encyclopedic, neutral way, in this article. Then, if it seems warranted, we could break off a separate article on Behavioral optometry. As it is, IMHO it would be a Herculean task to coordinate the two articles.

Support It seems like there is enough overlap that a merger would be a good idea. The Behavioral optometry article is rather muddy and even repetitive, it could use a rewrite. I like the structure of this article where it breaks down the vision therapies into various areas, where some of them have support from the medical community and some do not. Like acupuncture or chiropractics, there appear to be uses widely accepted as valid, others highly suspect, and both are supported by underlying theories that are not scientifically accepted. Brianyoumans (talk) 02:52, 8 April 2015 (UTC)

Comment: Lou has contacted me about this as I made some edits to this page sometime back. I work as an optometrist having qualified from Manchester Optometry School then having gained a qualification in Behavioural Optometry in Australia under the tutelage of Professor Ed Howell in 1992. Since then I have taught at three academic institutions in the UK, Manchester University, Aston University and Birmingham University as well as currently being involved in a pilot project regarding Brain Injury Rehabilitation at Derby Royal Infirmary based on behavioural optometry principles. I am also currently part of the way through NORA Fellowship (Neuro-Optometric Rehabilitation Association). I am not used to working on Wikipedia pages so bear with me if I do not understand the protocols straightaway (hence having written text on an inappropriate page). Having exchanged some messages with Lou, I am going to email two colleagues in the US (Bob Sanet and Len Press) and a colleague in Australia (Paul Graham) about this and ask for their input though as Lou's request will not have them partaking in the editorial process. I can also get Brendan Barrett (Bradford University) involved though he has reservations about the veracity of Wikipedia pages. Think that covers most things. Let me know how you wish to proceed.Peaceful07 (talk) 20:19, 8 April 2015 (UTC) Having read through the current Behavioral Optometry and Vision therapy pages I feel that the two topics are mutually exclusive and merging the two articles would not be appropriate. I think that it is better to keep the articles separate. Looking back at my comments in 2012 I was looking forward to there being two more even handed articles. This has not happened, perhaps because I have not contributed as I have been busy with brain injury initiatives in the UK. Differentiating behavioral optometry and vision therapy, behavioral optometry is more a philosophy of practice whereas vision therapy describes a specific line of treatment. Like a particular orthopaedic aurgeon might favour using physiotherapy and occupational therapy interventions more than another surgeon might, similarly someone practicing behavioral optometry might favour using particular clinical techniques in their assessment of a patient more than another optometrist might. Similarly, certain techniques used in vision therapy are used by practitioners who do not describe themselves as Behavioral Optometrists. For instance Brendan Barrett uses near retinoscopy techniques in his teaching clinics and in practice though would not describe himself as a Behavioral optometrist. Similarly I have been spending a proportion of my time teaching vision therapy techniques to rehabilitation consultants, physiotherapists and occupational therapists at the Derby Hospital and Newcastle Hospital Brain Injury Units so they can help their patients. As Anthony points out (Hi again Anthony) the subject could be written about in far more detail and from my point of view going back to my 2012 comments, a more balanced manner.Peaceful07 (talk) 19:40, 9 April 2015 (UTC)

Comment. I find the current situation with the two articles, as they stand for the moment, to be rather confusing to the reader, and would tend to share Lou's hope that "Having all this material in one article would facilitate fair and encyclopedic descriptions of the controversy and its boundaries, as well as of the non-controversial areas." However, if Peaceful07 is optimistic that he/she can improve the articles such as to more clearly set out the two topics and their interrelations, I see no reason to hurry to a merge for the moment. --Chris Howard (talk) 20:18, 9 April 2015 (UTC)

Hold off on merge: That's reasonable enough. Ceannlann gorm (talk) 11:21, 10 April 2015 (UTC)

Support original merger proposal. Tjlynnjr (talk) 21:47, 10 April 2015 (UTC).

Support original merger proposal. Famous_dog (c) 07:12, 17 April 2015 (UTC)

• Support merger. Alexbrn (talk) 06:33, 27 April 2015 (UTC)

It's been ages, and still no response, rewrite or constructive contribution has been forthcoming from Peaceful07, so are we going to merge these articles or what? Famous_dog (c) 09:22, 21 October 2015 (UTC)

• Reckon so. Alexbrn (talk) 12:36, 30 July 2016 (UTC)

 Done Alexbrn (talk) 13:00, 30 July 2016 (UTC)

Contradiction / strawman arguments

Isn't it a little contradictory that the lead says vision therapy is based on the pseudoscientific claim that "vision problems are the true underlying cause of learning disabilities", then states later on that "These optometric organizations are careful to distinguish, though, that vision therapy does not directly treat learning disorders"?

Far as I can tell (disclaimer, I am an optometrist who used to provide vision therapy but now mainly works in glaucoma management) none of these organizations is claiming that these vision problems cause learning disabilities. Many of the reviews which refute vision therapy seem to say that vision therapy advocates say it will treat learning disabilities but never actually cite any sources for examples where this claim has been made (ie. making straw man arguments). Granted, if you go back in history, some of the earlier individuals who developed vision therapy may have believed these claims but in modern times, that's not the case.

There's plenty of click-baity and kinda misleading articles out there titled things like "Vision therapy for ADHD" which then state that these visual problems may be misdiagnosed as or exacerbate learning disorders. But that's still not claiming that these "vision problems cause learning disabilities".Jasonkwe (talk) (contribs) 01:05, 2 April 2023 (UTC)

The source mentions "a long list of behavioral and learning problems which therapists claim are ultimately caused by vision problem". So that's the basis of the article text here. Bon courage (talk) 03:49, 2 April 2023 (UTC)

I'm not questioning what the article says. I'm questioning the fact that these claims are attributed to vision therapy proponents when there's no evidence of them making these claims. The only individuals and organizations mentioning these claims about "learning disorders being caused by vision problems" seem to be vision therapy's opponents because, as mentioned, official "optometric organizations are careful to distinguish, though, that vision therapy does not directly treat learning disorders".

When I was in school, it was pretty much drummed into us that binocular vision disorders are not equated to learning disorders. And any kind of claim alleging that is on the same level of wrong as "vaccines cause autism" and "the world is flat". Jasonkwe (talk) (contribs) 02:11, 4 April 2023 (UTC)

Wikipedia goes by sources, but a quick check in the 'real world' shows this kind of stuff[4] is deffo out there. Nothing new in making money off anxious parents with a health scam whether it's this, antivaxx or whatever! Bon courage (talk) 04:29, 4 April 2023 (UTC)

@Bon courage Ok. But learning disability is a very specific term for conditions which affect cognition or the ability to comprehend. That page you linked doesn't imply that visual problems cause issues with cognition. It does refer to "visual skills" which are claimed as essential for getting the visual input into the brain.

The analogy often used to explain these visual skills is to imagine a telescope. It's got good glass so it's capable of seeing things clearly. But if you take the eyepiece's focus knob and mess it up, you'll have a tough time seeing what you want to, no? Vision therapy people argue that not having the focus knob dialed in correctly is a deficiency in visual skills. And convergence insufficiency (CI) is another type of deficiency in visual skills.

Whether these other visual skills/problems aside from convergence insufficiency are as clinically significant and as treatable as convergence insufficiency is what's in contention.

But nobody is saying these visual skills ARE learning disabilities or cause them.

I don't like that some people might use such pitches to "prey" on desperate parents but that's not what we're discussing. Jasonkwe (talk) (contribs) 21:51, 5 April 2023 (UTC)

Well, you have your view; reliable sources have theirs. Which do you think Wikipedia follows? Bon courage (talk) 03:41, 6 April 2023 (UTC)

@Bon courage Well, if we go by the source being cited, it does not say that vision therapy proponents argue that vision problems are the root cause of learning disabilities. Learning disabilities have a strict definition and diagnostic criteria. That's not what they were referring to.

Honestly, I'm fine with the sentence that they use later on "The core claim of vision therapists, or behavioral optometrists, is that many children are misdiagnosed with learning and behavior disorders when in fact they have a subtle problem with vision". That at least makes sure we're all arguing about the same thing.

Jasonkwe (talk) (contribs) 02:54, 7 April 2023 (UTC)

Fair enough. The source does not specify "learning disabilities". Have changed. Bon courage (talk) 03:06, 7 April 2023 (UTC)

I think the second statement about the "core claim of vision therapists" is most accurate in describing what the central issue is: that some issues may be misdiagnosed as learning difficulties when they're actually due to deficiencies in visual skills. Jasonkwe (talk) (contribs) 00:07, 11 April 2023 (UTC)

Recourse for constant sabotage

This page is an embarrassment. It features extremely biased language and reads like a hit piece against a field of optometry that is widely used and applied with positive (and even, *gasp* scientifically peer-reviewed results).

A month or so ago I put a lot of effort into making a large page edit to improve neutrality. I did not remove a single bit of the criticisms cited by previous authors. I included sources for every change, except for changes to language and tone to improve neutrality. My writing was fair, and, unlike the current article, did not feature any illegitimate claims or inflammatory language.

The same user that rolled back my very labor-intensive effort has continuously sabotaged every attempt to improve the article for neutrality that followed.

I am not used to contributing to Wikipedia in this way, but it is incredibly problematic to optometry to let this page stand as is. We see feedback from patients attempting to educate themselves about this field of optometry who are confused, flummoxed, mystified. Many are confused as to how such an obviously biased and emotionally-charged article can remain on a generally well-respected information source like Wikipedia. If anything, the extremity of obvious non-neutrality in the current page makes the average person recoil in confusion and undermines the legitimacy of Wikipedia in general.

What can we do to prevent the continuous sabotage of this page? Lechevaler (talk) 03:53, 25 May 2023 (UTC)

You efforts seem mostly to be whitewashing the page. Wikipedia isn't going to do that. Also be aware of WP:COI. Bon courage (talk) 06:34, 25 May 2023 (UTC)

My edits did not remove a single piece of cited information that was critical of vision therapy.

That is not “whitewashing.”

That is applying what I understand to be the rules of neutral language as opposed to inflammatory, biased, emotionally charged language that amplifies narratives about optometric vision therapy that are patently false. Do the pages for Occupational Therapy and Physical Therapy obsess over the quackery that exists on the fringe of these procedures and occupations? Is it neutral or factually accurate to apply generalizations to an entire field of widely-accepted (yes, widely accepted in modern optometry, neurology, and elsewhere) as “pseudoscience” and “alternative medicine” based on non-mainstream claims by certain practitioners that overreach on the scope of its application?

Those who continue to roll back attempts to fix this page seem to lack insight on what this field actually claims to do and what the research basis has shown.

If a cardiologist made edits to the Wikipedia page for heart arrhythmia would you roll back their changes based on a “conflict of interest?” I am certified by the College of Optometrists of Visual Development and have worked with my father, who is an OD, for my entire life. I also comanage patients with every local ophthalmologist, who frequently refer to me and see the results of orthopedic training.

The page in its current state is confusing and offensive to laypeople with no dog in this “fight.” Step back a little bit and think about the way it reads. It reads like it was written by someone with a serious vendetta. It is not acceptable in its current state. Lechevaler (talk) 08:22, 25 May 2023 (UTC)

The thing is, it's possible to compare the consensus version[5] of the WP:LEDE with your version.[6] Your version is completely whitewashed, since it removes the content stating that VT is (in the main) discredited pseudoscience for which un-evidenced claims are made by its proponents. Wikipedia has special rules for WP:FRINGESUBJECTS like this, and their fringe nature has to up-front and clear. If you want more views, raise a query at WP:FT/N. Bon courage (talk) 13:34, 25 May 2023 (UTC)

“based around the pseudoscientific claim that vision problems are the true underlying cause of learning difficulties, particularly in children.”

This is patently untrue and a flawed thesis statement.

Vision therapy uses eye exercises to improve binocular vision. Although it has been claimed (with only a few studies such as the CITT backing it up) that vision correlates with learning problems (I mean… if you can’t see you can’t read, so I don’t even know what’s so controversial about this idea) , this is not the “basis” of this field of optometry.

Vision therapy is not ““based around the pseudoscientific claim that vision problems are the true underlying cause of learning difficulties.” It is based on the proven claim that eye exercises can improve binocular coordination. Regardless of what any organization says about the correlation between vision and learning disabilities, that is not the “basis” of this field of treatment.

once again I will emphasize the current article has created a pretty intensely biased strawman about what vision therapy actually is. That is the only thing that I changed about the article. I agree that such claims lack scientific evidence and included all the references that point out and/or debunk the various unsupported claims that have been made. The idea that those unsupported claims that improved visual function correlates with improved behavior and reading are the actual “foundation” for eye exercises that have been scientifically proven to enhance binocular vision is simply false. Lechevaler (talk) 20:42, 25 May 2023 (UTC)

An actual certified vision therapist is telling you that the basis for vision therapy is the application of eye exercises to improve binocular vision performance.

The article is telling the world that the basis for vision therapy is some bizarre fantasy about learning disabilities.

This is the definition of a strawman. This is unacceptable. Lechevaler (talk) 23:37, 25 May 2023 (UTC)

But if you look at (say) doi:10.1017/9781316798096.007 it says

Vision therapists suggest these exercises improve visual processes and therefore make an individual more responsive to educational instruction ... . Unfortunately, there is currently inadequate empirical support to suggest vision therapy is effective for improving reading and writing skills ... Literature reviews indicate studies examining vision therapy are generally methodologically flawed or characterized by professional opinion as opposed to rigorous empirical investigations. Moreover, assertions of the effectiveness of vision therapy are often found in newsletters, brochures, books that do not present empirical support ...

Bon courage (talk) 05:46, 26 May 2023 (UTC)

Yep. That is perfectly consistent with what I just told you and also perfectly consistent with what existed in my edit of the article. Yep, many vision therapists suggest that these exercises improve visual processes and therefore make an individual more responsive to educational instruction. Yep, that is not a suggestion that is supported by sufficient scientific evidence. Yep, yep, yep.

And yet, still, somehow pseudoscientific claims about all behavioral problems being the result of vision disorders are, still, again, NOT the “basis” of vision therapy. The article as it stands features a thesis statement that is, by all imaginable standards, a lie at best, a rotten lie at worst. Thanks for sharing more information that is 100% supportive of the article as I edited it. I appreciate it. Lechevaler (talk) 09:34, 26 May 2023 (UTC)

Not really, but it is consistent with the cited source:

The core claim of vision therapists, or behavioral optometrists, is that many children are misdiagnosed with learning and behavior disorders when in fact they have a subtle problem with vision. ...That is a pretty dramatic claim, utterly lacking in evidence. As with many dubious health claims, the scientific evidence has been heading in quite a different direction.

Bon courage (talk) 12:59, 26 May 2023 (UTC)

A certified vision therapist is telling you, right now, that that is not the “core claim” nor the “basis” for vision therapy. You have a primary source right in front of you and you keep copying and pasting third-party criticisms that have nothing to do with the edits I made to the page. Edits which acknowledge that those claims are not supported by scientific evidence while also correcting the thesis statement to the actual, factual basis for vision therapy, which is the application of eye exercises to improve binocular vision performance. Lechevaler (talk) 21:30, 26 May 2023 (UTC)

You're making the WP:BIGMISTAKE. Bon courage (talk) 04:06, 27 May 2023 (UTC)

That’s cute that you wrote a little essay to cover these situations, however, I would like to point out that (as I’m sure you must be aware of by now) the sources you are using to support “consensus” are part of a wider inter-disciplinary political problem outside of Wikipedia between ophthalmology and optometry and are, themselves, problematic with bias and strawmen regarding what vision therapy is & what mainstream certified practitioners claim to do.

By referring only to those sources and ignoring primary sources from the optometric perspective, an article with obvious bias results.

Once again, my version of the article goes to great lengths to acknowledge this issue and all relevant criticisms while also presenting the optometric perspective, offering a much more more accurate & politically neutral picture of this field of study. This is not “whitewashing,” as you repeatedly claim, as it does not erase one iota of the criticisms and issues that appeared in all previous versions of the article. It is a necessary change for the betterment of Wikipedia in general. Lechevaler (talk) 23:04, 27 May 2023 (UTC)

See WP:RS and WP:PST. Brunton (talk) 06:59, 29 May 2023 (UTC)

Split article?

Perhaps it would be a good idea to split this article into Orthoptic vision therapy and Behavioral vision therapy? AlexChillOut (talk) 04:56, 27 May 2023 (UTC)

Orthoptic vision therapy is Orthoptics, which already exists. It's not exclusive to vision therapists though. Bon courage (talk) 05:18, 27 May 2023 (UTC)

In that case, perhaps turning this page into a disambiguation page that leads to both the currently existing orthoptics page and a new behavioral vision therapy page might be more appropriate. AlexChillOut (talk) 06:05, 27 May 2023 (UTC)

It appears my suggestion has been moved to a new thread, here's my reasoning on why:

• The current article conflates orthoptic vision therapy with behavioral vision therapy, despite these two being very different in terms of effectiveness and scientific consensus.
• This conflation leads to orthopic vision therapy being labeled as pseudoscientific in this article, despite the sources labeling it as pseudoscientific only pertaining to behavioral vision therapy.
  • Some citations where this is an issue include: 3, 4, 5, 6,
• Editors attempting to fix orthoptic vision therapy being labeled as pseudoscientific end up also mislabeling behavioral vision therapy as scientific.

I just made an edit that hopefully separates these two fields more, however I believe that separating these concepts and turning the vision therapy page into a disambiguation page would make this separation more apparent. AlexChillOut (talk) 06:04, 27 May 2023 (UTC)

Looks like I forgot to put etc. at the end of the citations list, whoops.. AlexChillOut (talk) 06:28, 27 May 2023 (UTC)

The trouble is this is your own original research, and goes against the sources which say VT has a huge range of stuff in it (one of which is sensible). This is like many quackeries - e.g. naturopathy recommending a healthy diet. We really need to stick to the sources on this. Bon courage (talk) 08:10, 27 May 2023 (UTC)

Could you explain how this is original research? I am going off of the sources cited here, which explicitly state that behavioral vision therapy is what they are considering pseudoscience. Some of these sources have this in the title itself, and from my understanding original research != reading sources on Wikipedia AlexChillOut (talk) 19:57, 27 May 2023 (UTC)

It's because the sources don't say VT "can be divided into two main fields". The cited Novella source defines it as

the notion that exercises and special glasses can treat a long list of behavioral and learning problems which therapists claim are ultimately caused by vision problems.

and later says of the one or two claims with evidence

This is also a common pattern that we see in dubious professions – there may be kernels of truth here and there, but the core philosophy is not valid and the majority of the less plausible claims are not true. Often proponents use the kernels to validate the whole, and this is also not legitimate.

I'm open to improving the wording but we need to be aligned with the framing in sources, that this is a dubious therapy overall with spots of less problematic practices.

What is probably our strongest source, doi:10.1017/9781316798096.007, has VT and BO as synonymous

Behavioral optometry (or vision therapy) is an extension of traditional optometry in which practitioners employ a holistic approach to the treatment of visual disorders.

Bon courage (talk) 04:03, 28 May 2023 (UTC)

Ah, I see. From what I saw of the sources it mainly divided vision therapy into orthoptic/behavioral vision therapy (or strabismic/non-strabismic), but that source was one I did not see. I still think that orthoptic vision therapy still needs to be separated from behavioral vision therapy a bit more, as many of the sources specify that they are talking about behavioral vision therapy and not orthoptic vision therapy.

The statement near the beginning in particular I am a bit skeptical of, as "Neither the American Academy of Pediatrics nor the American Academy of Ophthalmology support the use of vision therapy" is true for behavioral vision therapy, but not true for orthoptic vision therapy (see https://www.aao.org/education/disease-review/adult-strabismus-orthoptist-perspective, I'm assuming here that publishing information in support of orthoptic vision therapy == supporting orthoptic vision therapy).

Perhaps other fields of vision therapy need to be distinguished on this page as well? AlexChillOut (talk) 07:07, 28 May 2023 (UTC)

VT is BO, per our best source above (and BO redirects here). Bon courage (talk) 07:10, 28 May 2023 (UTC)

Not according to several different sources I've found, including but not limited to https://aapos.org/glossary/vision-therapy, https://www.optometrists.org/vision-therapy/guide-to-vision-therapy/what-is-vision-therapy/, https://www.childrenshospital.org/programs/vision-therapy-service/faqs, and https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/vision-therapy.

It seems to me that several different fields of vision therapy are calling themselves just vision therapy, and as the source that lists VT as BO is specific to psychotherapeutic pseudoscience, in which only behavioral vision therapy would fall, I believe that might be what's happening there. AlexChillOut (talk) 07:50, 28 May 2023 (UTC)

It's a mess, but I think the way we do things at the moment is reasonable. We just cannot be definitive about what VT is, I suppose. Bon courage (talk) 03:04, 29 May 2023 (UTC)