The British Association of Behavioural Optometrists, founded in 1991, is a United Kingdom based organisation representing Behavioural Optometry. Its aims are to develop, disseminate, and promote training and awareness of the Behavioural approach to vision care, both to the profession of optometry and to the public and other professions at large.
BABO offers many continuing education opportunities throughout the year including their Optometric Vision Therapy course series made up of five separate courses from beginner level to advanced techniques. For more information about BABO and their educational opportunities, visit their website and watch this space as they begin to offer more through the I HEART VT platform.
The British Association of Behavioural Optometrists presents:
How we understand our world:
Current concepts of extra-retinal information and oculomotor control
Perception is commonly described as the brain’s interpretation of the information it receives, whereby different sensory modalities (vision, proprioception, tactile and vestibular input etc) are integrated to create a consistent and valid representation of our surroundings.
Numerous sensory receptors contribute to this form of multisensory integration (as the name implies), yet some of them have a lesser impact on the brain than others. In fact, signals from some receptors are filtered out early in the process, while others are inhibited shortly after they have reached their destination.
This type of filtering, adaptation and tuning of sensory information is executed by specific pools of neurons, located in the reticular formation of the brainstem. The neurons serve as gatekeepers to ensure that only important and vital information is forwarded to the various cortical and subcortical regions of the brain. Lesser important information is effectively eliminated in order to reduce the amount of “neural noise” in the system.
Even important information may be filtered out or suppressed if the signal fails to fulfil the gatekeepers requirements. Structural and functional changes, occurring at the receptor level, may therefore have implications for the process of the neural integration, which takes place higher up in the system.
The visual system is, under normal circumstances, prioritised by the gatekeepers due to its unique structural and functional organization. Not only does this system provide the brain with a larger amount of information and stimulate more neurons compared to other senses, but also the information itself arises from a diverse complement of highly specialized sensory receptors.
Information from photoreceptors and photosensitive ganglion cells is cross-referenced with information from proprioceptors in the oculomotor system. Sensory information from the latter type of receptors, often referred to as extra-retinal information, provides the brain with detailed knowledge about the state of contraction of smooth muscles in the ciliary body as well as the degree of overlap between the contractile proteins in the cross striated muscle fibres in the extraocular muscles.
This enhances the brain's ability to determine the pointing direction of the eyes in relation to the position of the head and torso, which in turn creates a sound basis for determining the exact location of a specific object, its relative size and whether it is stationary or not in relation to body movements. Mapping of the neural pathway from ocular proprioceptors has revealed that a multitude of nerve fibres terminate in the superior colliculus, which has reciprocal connections with cortical regions in all of the brains lobes, including areas of the prefrontal lobe , known to be involved in cognitive functions.
Furthermore, the information provided by these receptors also support a broad spectrum of other non-visual biological functions and even contribute in the tuning and adaptation of the other senses.
From this follows that any interference with the information arising from extra- retinal receptors will have an adverse effect on our perception, our understanding of the surrounding world, our cognitive functions as well as our pattern of behaviour.
When one sensory modality becomes ambiguous or is inconsistent with the others (sensory rivalry), the brain becomes confused and the interpretation of the sensory information becomes less accurate (neural integration dysfunction). This will in turn affect the activity of the motor signal and the behavioural response.
It is reasonable to assume that a significant number of the perceptual, visual, and cognitive anomalies we encounter in the clinic are caused by the brain’s misinterpretation of extra-retinal information, rather than problems with retinal information (this is why dedicated clinicians are reluctant to use visual equity as the only marker for the patients perceptual quality). On the bright side, we now know that the plasticity in the brain is far greater than previously assumed and that neuromuscular functions can be restored by stimulation of receptors, synaptic connections and contractile proteins.
It is legitimate to argue that detailed knowledge about extra-retinal information can serve as a powerful clinical tool in the management of binocular anomalies, perceptual and cognitive problems.
This presentation aims to summarize the most pertinent results from 3 decades of research on the oculomotor system. The majority of the research was undertaken at the biomedical research unit at University of South East Norway in collaboration with other academic and medical institutions.
The various sessions will focus on several aspects of visual perception and aims to provide answers to the following mind-boggling questions:
The structural and functional organization of the oculomotor system
1. Extra-retinal information is claimed to be important for a broad variety of visual functions, but where in the oculomotor system do these receptors reside and what kind of eye movements will suffer the most if information from these receptors becomes ambiguous? What are the potential clinical implications of late development and/or developmental arrest of these receptors? Are they implemented in the aetiology of oculomotor anomalies and will surgical manipulation of these receptors have any consequences for the post- operative angle of deviation and the patient’s perceptual experience? What is the potential gain by enhancing the functional capacity of proprioceptive receptors and is it possible to achieve this through various non-invasive methods of treatment?
2. According to previous models of the oculomotor system there is a division of labour between supra-nuclear neural components and sub-nuclear muscular components, where the latter components are claimed to only execute the neural commands initiated by the supra-nuclear components. Is this model consistent with clinical experience or is the sub-nuclear system more sophisticated than previously assumed. Do we have sufficient knowledge of the neural pathway responsible for providing the brain with proprioception and where does the actual signal terminate in the brain? neural structures neurones will receive this information.
3. In recent years, it has been promoted that the plasticity of the brain is greater than previously assumed. How great is this plasticity and are there any limitations in relation to the numerical age of the patient? Are all supra-nuclear structures equally willing to undergo structural changes and alter their functional capacity?
4. Can increased sensory input to the brain through proprioception stimulate the neural network? Is it possible to increase the proliferation of new synaptic connections and other vital components in the neural network through non-invasive methods? Can anomalies in proprioceptive feedback to the brain lead to decline in cognitive/executive functions.
Session #1 -- Wednesday, July 1st @ 19.00 UK Time - 90 minutes
Session #2 -- Sunday, July 26th @ 19.00 UK Time - 90 minutes
Session #3 -- Sunday, August 23rd @ 19.00 UK Time - 90 minutes
Session #4 -- Sunday, August 30th @ 19.00 UK Time - 90 minutes
Session #5 -- Sunday, September 20th @ 19.00 UK Time - 90 minutes
Payment can be made by Credit Card, Debit Card, or PayPal Account
Refunds will not be available once the seminar begins.
Registration includes access to the live seminar sessions and access to the session recordings for 1 year.
7 BABO CET points available for BABO members.
GOC CET points will not be provided.
This seminar is appropriate for Optometrists, Vision Therapists, Optometry Students, and Allied Health Professionals
This seminar is presented in English
Open to participants around the world
Technical requirements for attending:
Stable internet connection
Dr. Jan Richard Bruenech is a professor of ocular anatomy and the founding director of the Biomedical Research Unit at the faculty of Health and Social Sciences at the University of Southeast Norway.
He holds a degree in biomedicine as well as a degree in Optometry and Visual Science. He also holds a PhD in ocular anatomy with focus on the neuroanatomical organization of the visual system and the brain's ability to coordinate eye movements. The two latter degrees were obtained at City University in London.
His organizational skills and competence has been obtained through a degree in research leadership at the faculty of medicine at Oslo University, as well as through various administrative positions at the University of Southeast Norway, including head of department, vice Dean and head of research.
These formal positions along with his dedication and enthusiasm has enabled him to build an extensive academic network. He currently collaborates with medical and academic institutions in both Europe and the USA and has done considerable research on the human central nervous system with emphasis on visual functions. He has also done comparative studies using sophisticated biomedical research methodology, including injection of stem cells into the cerebral cortex of mammals.
He has published a broad variety of scientific papers and textbook- chapters and has presented his research at scientific and medical conferences worldwide. He is a praised presenter and frequently invited as key speaker at these conferences.
His research has received a lot of international attention and the Norwegian Research Council and other academic authorities have repeatedly described his work as innovative and novel. This has resulted in a number of grants and awards as well as substantial financial support over the years.
He currently teaches a variety of biomedical topics to optometry students, nurses, physiotherapists as well as to medical students, at all academic levels. He also supervises Master and PhD students at the faculty in Norway as well as in other European countries.
Prescribing, From the Inside Out
The power of lenses from the patient's point of view
Have you ever had a patient complain about their new prescription? Have you ever seen small changes in prescription make huge differences to a patient? Have you grappled with wondering what the long-term implications are of what you prescribe or what factors other than acuity you should consider? Then join us on this course by Dr. Rob Lewis on I HEART VT.
Dr. Lewis has been in private practice for 38 years and is co-owner and managing partner of Family Optometry in Chandler, Arizona, USA. He received his bachelor’s degree from Pacific University and his optometry degree from Pacific University College of Optometry. He is a Past-President of the Optometric Extension Program (OEP) and a Fellow of the College of Optometrists in Vision Development (COVD). He is a member of the British Association of Behavioral Optometrists (BABO) and a charter member of the Neuro-Optometric Rehabilitation Association (NORA).
Dr. Lewis is extensively active in optometric education. He is also an instructor, and co-creator of, the OEP Clinical Curriculum Courses as well as an instructor of the BABO OVT Strabismus and Amblyopia course. He is an adjunct professor for Pacific University College of Optometry and hosts optometry student externs in his practice for part of their fourth-year clinical learning requirements.
Dr. Lewis teaches and lectures on numerous topics including prescribing, learning related vision problems, strabismus and amblyopia, neuro-optometric rehabilitation, myopia, and more.
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