- Email: [email protected]
A vision science reality check
GUEST EDITORIAL Michael J. Giese, O.D., Ph.D., and Kenneth R. Seger, O.D., M.Sc.
A vision science reality check
O
ptometry is a constantly evolving profession with an expanding scope of practice. However, we question if the profession is embracing all of the disciplines needed to support this development. Part of this questioning, we feel, is related to how our profession sees its role in the vision science arena. We would like to propose changes to how the profession defines some important words or concepts that are necessary for incorporating the existing and expanding scientific knowledge base. First of all, the term vision science has no clear definition. The Dictionary of Visual Science does not even list vision science as a term to be defined, nor do many dictionaries. The only definitions of vision science that we could find were in the populist Internet-based dictionaries Wikipedia and the Free Dictionary by Farlex. Wikipedia defines vision science as ‘‘the science dedicated to the interdisciplinary study of visual perception and the visual system. It includes cognitive psychology, neuroscience, computer science, psychophysics and optometry.’’ The Free Dictionary (http://medical-dictionary.thefreedictionary.com/vision) defines vision science as ‘‘the scientific study of how the visual system contributes to an understanding of the environment by processing and interpreting the light stimulation to the eye. ’’ These are very constricting definitions for use by a primary care profession. What about microbiology, immunology, pathology, molecular biology, genetics, mechanisms of ocular disease, treatment of visual disease, etc.?– Don’t these disciplines contribute to the global field of vision science? Optometry has focused on the disciplines of optics, psychology, neuroscience, computer science, and
psychophysics (we will call these ‘‘traditional’’ vision sciences) for such a long time that we wonder if the profession has forgotten that times are (and have been) ‘‘a-changing.’’ Optometry has been a leader in the ‘‘traditional’’ vision science fields since the time of Meredith Morgan and Glenn Fry. Many of our professions’ recognized leaders and academics have excelled in these areas of research. Optometry has dominated development of and research in contact lenses and has been at the forefront of the recent interest in wavefront ocular aberrations.1 Graduate programs in vision science (ne´e physiological optics) at the traditional state-supported university programs developed out of the physics background from whence optometry originated. The programs at The Ohio State University, University of Houston, University of California at Berkeley, Indiana University, and University of Alabama at Birmingham have all educated optometrists and professional researchers based on this historical background. The Ezell Fellowship program started in 1947 with the purpose of educating primarily optometrists in optometric research and education. The list of recipients of these fellowships is truly impressive when one sees the contributions made to our profession and to the world of vision (science) in general. Other terms related to an expanded definition of vision science also need to be emphasized in the profession of optometry; these are clinical science, clinician scientist and translational research. The journal Clinical Science (www.clinsci.org/cs/aims.htm) defines clinical science as ‘‘the whole range of biochemical, physiological,
1529-1839/10/$ -see front matter Ó 2010 American Optometric Association. All rights reserved. doi:10.1016/j.optm.2009.10.004
Michael J. Giese, O.D., Ph.D. immunological and other approaches that may have relevance to disease in humans, particularly those which explore integrative biology of systems and pathways and the translation of molecular mechanisms to clinical applications.’’ Our profession has done very well in the clinical science field and would be expected to continue to do so. We should all be very proud of what our profession has accomplished with the Contact Lens Evaluation of Keratoconus (CLEK) and Convergence Insufficiency Treatment Trial (CITT).2,3 The term clinical science can be confusing because one might also wonder what kind of science does a basic scientist conduct when looking at mechanisms of and/or treatment of a patient disease in an in vitro or animal model? We would define this as clinical science. Maybe the science of using patients and patient information should be referred to as patient-based science? And what about the clinician scientist? Is a clinically trained optometrist who
56 is conducting basic science (so-called bench research), a clinically trained optometrist who is conducting clinically relevant science or someone who conducts patient-based science? We suggest that if one uses a broad scope for the field of vision science as well as an inclusive definition of clinical science then someone doing research in any manner listed above would be a clinician scientist. We propose that the traditional definition of vision science be updated to encompass molecular biology, microbiology, pharmacology, immunology and any other ‘‘ology’’ that has relevance to our profession. We suggest that optometrists embrace the definition of clinical science used by Clinical Science when thinking about research priorities. By incorporating this definition under the vision science
Guest Editorial umbrella, all researchers who are biomedically trained and focused, as well as those who are patient-based trained and focused, will be included. So why make this change? Reinterpreting how optometry looks at vision science will open existing disciplines of research that optometry has overlooked. This might affect education by changing how potential students see optometry in the medical research arena. It might make it more attractive for clinical scientists and PhDs to work in our profession rather than medicine. It might make all the different special interest groups feel like optometry offers a ‘‘home’’ for them and their discussions. It may change what the general, primary care optometrist perceives to be the purview of optometry rather than solely medicine and ophthalmology.
References 1. Special Issue. Wavefront Optics. Clin Exp Optom 2009;92:171-328. 2. Wagner H , Barr JT , Zadnik K . Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: methods and findings to date. Cont Lens Anterior Eye 2007;30:223-32. 3. Convergence Insufficiency Treatment Trial Investigator Group. Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol 2008;126:1336-49.
Corresponding author: Michael J. Giese, O.D., Ph.D. Associate Professor of Optometry Nova Southeastern University 3200 S. University Drive, #1456 Ft. Lauderdale, Florida 33328 [email protected]
A vision science reality check
O
ptometry is a constantly evolving profession with an expanding scope of practice. However, we question if the profession is embracing all of the disciplines needed to support this development. Part of this questioning, we feel, is related to how our profession sees its role in the vision science arena. We would like to propose changes to how the profession defines some important words or concepts that are necessary for incorporating the existing and expanding scientific knowledge base. First of all, the term vision science has no clear definition. The Dictionary of Visual Science does not even list vision science as a term to be defined, nor do many dictionaries. The only definitions of vision science that we could find were in the populist Internet-based dictionaries Wikipedia and the Free Dictionary by Farlex. Wikipedia defines vision science as ‘‘the science dedicated to the interdisciplinary study of visual perception and the visual system. It includes cognitive psychology, neuroscience, computer science, psychophysics and optometry.’’ The Free Dictionary (http://medical-dictionary.thefreedictionary.com/vision) defines vision science as ‘‘the scientific study of how the visual system contributes to an understanding of the environment by processing and interpreting the light stimulation to the eye. ’’ These are very constricting definitions for use by a primary care profession. What about microbiology, immunology, pathology, molecular biology, genetics, mechanisms of ocular disease, treatment of visual disease, etc.?– Don’t these disciplines contribute to the global field of vision science? Optometry has focused on the disciplines of optics, psychology, neuroscience, computer science, and
psychophysics (we will call these ‘‘traditional’’ vision sciences) for such a long time that we wonder if the profession has forgotten that times are (and have been) ‘‘a-changing.’’ Optometry has been a leader in the ‘‘traditional’’ vision science fields since the time of Meredith Morgan and Glenn Fry. Many of our professions’ recognized leaders and academics have excelled in these areas of research. Optometry has dominated development of and research in contact lenses and has been at the forefront of the recent interest in wavefront ocular aberrations.1 Graduate programs in vision science (ne´e physiological optics) at the traditional state-supported university programs developed out of the physics background from whence optometry originated. The programs at The Ohio State University, University of Houston, University of California at Berkeley, Indiana University, and University of Alabama at Birmingham have all educated optometrists and professional researchers based on this historical background. The Ezell Fellowship program started in 1947 with the purpose of educating primarily optometrists in optometric research and education. The list of recipients of these fellowships is truly impressive when one sees the contributions made to our profession and to the world of vision (science) in general. Other terms related to an expanded definition of vision science also need to be emphasized in the profession of optometry; these are clinical science, clinician scientist and translational research. The journal Clinical Science (www.clinsci.org/cs/aims.htm) defines clinical science as ‘‘the whole range of biochemical, physiological,
1529-1839/10/$ -see front matter Ó 2010 American Optometric Association. All rights reserved. doi:10.1016/j.optm.2009.10.004
Michael J. Giese, O.D., Ph.D. immunological and other approaches that may have relevance to disease in humans, particularly those which explore integrative biology of systems and pathways and the translation of molecular mechanisms to clinical applications.’’ Our profession has done very well in the clinical science field and would be expected to continue to do so. We should all be very proud of what our profession has accomplished with the Contact Lens Evaluation of Keratoconus (CLEK) and Convergence Insufficiency Treatment Trial (CITT).2,3 The term clinical science can be confusing because one might also wonder what kind of science does a basic scientist conduct when looking at mechanisms of and/or treatment of a patient disease in an in vitro or animal model? We would define this as clinical science. Maybe the science of using patients and patient information should be referred to as patient-based science? And what about the clinician scientist? Is a clinically trained optometrist who
56 is conducting basic science (so-called bench research), a clinically trained optometrist who is conducting clinically relevant science or someone who conducts patient-based science? We suggest that if one uses a broad scope for the field of vision science as well as an inclusive definition of clinical science then someone doing research in any manner listed above would be a clinician scientist. We propose that the traditional definition of vision science be updated to encompass molecular biology, microbiology, pharmacology, immunology and any other ‘‘ology’’ that has relevance to our profession. We suggest that optometrists embrace the definition of clinical science used by Clinical Science when thinking about research priorities. By incorporating this definition under the vision science
Guest Editorial umbrella, all researchers who are biomedically trained and focused, as well as those who are patient-based trained and focused, will be included. So why make this change? Reinterpreting how optometry looks at vision science will open existing disciplines of research that optometry has overlooked. This might affect education by changing how potential students see optometry in the medical research arena. It might make it more attractive for clinical scientists and PhDs to work in our profession rather than medicine. It might make all the different special interest groups feel like optometry offers a ‘‘home’’ for them and their discussions. It may change what the general, primary care optometrist perceives to be the purview of optometry rather than solely medicine and ophthalmology.
References 1. Special Issue. Wavefront Optics. Clin Exp Optom 2009;92:171-328. 2. Wagner H , Barr JT , Zadnik K . Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: methods and findings to date. Cont Lens Anterior Eye 2007;30:223-32. 3. Convergence Insufficiency Treatment Trial Investigator Group. Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol 2008;126:1336-49.
Corresponding author: Michael J. Giese, O.D., Ph.D. Associate Professor of Optometry Nova Southeastern University 3200 S. University Drive, #1456 Ft. Lauderdale, Florida 33328 [email protected]