What is the difference between an ophthalmologist, an optometrist and a behavioural optometrist?

  • Optometrist: the vision professional whose job it is to study and treat visual dysfunction and to compensate the different refractive errors (myopia, hypermetropia, astigmatism, etc.) using non-invasive methods (glasses, contact lenses, etc.).
  • Although no regulated specialisations exist and all optometrists have the same qualifications in the eyes of the law, there are different branches and specialisations in accordance with the post-graduate studies and continuous training undertaken by each optometrist. Those optometrists dedicated to treating the various visual anomalies and, furthermore, visual development and perception problems are, due to their comprehensive training and wide experience in fields as specific as these, known as behavioural optometrists.
  • Ophthalmologists: SThese are doctors specialising in diseases of the eye whose job it is to treat them and ensure the eyes are healthy and see correctly. Their speciality involves prescribing medicines for treating diseases and performing surgical operations. Ophthalmologists and optometrists have one thing in common in that they both perform eye refractions and prescribe lenses.

What is Optometry?

This is the speciality that studies the visual mechanisms and non-pathological disorders they can present. Vision is an extremely complex process that involves a multitude of physiological mechanisms and activities.

“Seeing well” does not mean seeing clearly and in focus. It also means perceiving, understanding, remembering, discerning shapes, colours, movements, etc., calculating the distance and speed of objects. And doing all of the above comfortably and effectively.

Therefore, are sight and vision different?

Sight: Synonymous with visual acuity (the capacity to see clearly). It only occurs in the eyes.

Vision: The ability of the brain to extract and process the information reaching the retina and act in accordance with it.


Our sight enables us to “see” the registration number of a car at a great distance, but it is our vision that allows us to interpret the speed at which the car is approaching, predict the route it is going to travel and calculate the time it will take to reach the point at which we wish to cross the street.

The registration number is seen, but the speed is not, although in order to be able to construct a mental image of a vehicle’s speed we require visual information.

Why has nobody told me about Vision Therapy befor?

The speciality known as Vision Therapy could be considered as something relatively new here in Spain. In the United States, on the other hand, they have been working in this area for over 50 years in a multi-disciplinary way that involves all the professionals who work within the field of vision.

In Spain there are very few professionals dedicated to Vision Therapy, and this is why so little is known about it.

How can Vision Therapy help to solve vision problems?

Using different techniques, depending on the type of problem, to achieve maximum performance efficiency so that everyday tasks can be carried out in the most comfortable way possible.

How can I detect whether my child has a vision problem?

Observation, by parents and teachers, of the child’s visual habits is, on occasions, decisive for detecting possible problems of vision.

Some possible symptoms in children might be:

  • Sometimes one of their eyes wanders.
  • Reading very slowly and having to follow the text with their finger.
  • Speaking the words when asked to read in silence.
  • Not knowing how to explain what has just been read.
  • Suffering from headaches or rubbing of eyes when doing close up work.
  • Blurred or double vision when reading or writing.
  • Closing or covering one eye on occasions.
  • Writing with their face down close to the paper.
  • Inclining their head when studying or watching TV.
  • When reading, moving their head instead of their eyes.
  • Writing slopes upwards and/or downwards with irregular letter formation.
  • Getting lost when having to look from blackboard to desk, or when copying from the blackboard into a textbook.
  • Having obvious difficulties when practicing sport, reading or writing.
  • Reversing letters (b-d, p-q).
  • Holding books very close to their faces.
  • When reading, skipping individual words or complete lines; also reading the same line twice.
  • Easily losing attention and distracting their classmates.

If between 3 and 5 of the above symptoms are evident, your son/daughter might well have a vision problem. You should consider having their vision checked by a Behavioural or Developmental Optometrist.

At which age can they go for their first eye examination?

The correct answer would be: “the sooner the better”.

If there is a history of vision problems in your family, the first visual examination should be made before your child turns one, but examinations can be carried out on babies in their first week of life.

How often is it recommendable to go for a visual examination?

We advise having yearly check-ups: prevention is better than cure.

My child has a learning difficulty. Could it be related with a vision problem?

Bearing in mind that over 70% of what we learn at school is absorbed via the visual system, it goes without saying that there is an exceedingly close connection between learning and vision.

Children must have other skills apart from good sight to be able to learn and understand what they read. They must be able to make focal changes, perform visual scans or have good coordination between both eyes, have good eye-hand coordination, etc. If these skills have not developed, or have not developed in an inadequate manner, learning will be both difficult and stressful.

But… My child can see very well!

Seventy-three percent (73%) of children with learning difficulties have vision problems and, despite this… see well!

For a student to see what is written on a blackboard seeing well is necessary but, bearing in mind that 80% of “school time” is spent doing close-up work (excluding those periods of physical and recreational activity), what is the use of having good long-range vision if a child is unable to make a prolonged visual effort at 30 or 40 centimetres and cannot read for longer than 10 minutes?

LMost of the vision tests usually carried out only measure visual clarity at distance, which is why many of the problems that affect learning go undetected.

What must be done if a child is suspected of having a vision problem that is having a detrimental effect on his/her learning?

If a child is experiencing any of the problems mentioned in the perceptual visual skills table, he/she must be sent for a visual processing examination.

This is a special examination that normally lasts about 3 hours (visual examination: 1 hour, perception examination: 2 hours). The tests carried out examine the areas mentioned in said table and can give us a better understanding of why a child is not fulfilling all of his/her academic potential.

It is important to stress that an examination of the child’s vision alone is not sufficient. The optometrist can carry out tests that specifically examine problems of visual processing or of visual perception. You will need to ask the optometrist for this type of appointment before you book a visit.

How can vision therapy help my child with his/her learning difficulty?

Vision Therapy helps children with learning difficulties to rebuild their visual skills in a suitable manner so as to make the learning process easier.

Following this treatment, children’s academic performance significantly improves.

Will Vision Therapy alone eliminate a child’s learning difficulties?

Don’t expect miracles. Visual Therapy alone will not result in a direct improvement of a child’s reading skills or of his/her learning in general. However, visual processing deficiencies often throw up barriers that hinder learning efficiency.

Therefore, any type of improvement with respect to visual skills will result in greater efficiency and concentration where learning is concerned and will enable the child to benefit from remedial classes. In the majority of cases, the child will require study support classes to overcome reading, mathematics or other academic problems. The combination of Vision Therapy and support classes often leads to a better general result.

Do not hesitate to ask us if you would like more information.

Is the patient’s collaboration important? What about the parent’s (if the patient is a child)?

The success of the Vision Therapy depends, to a great extent, on the perseverance and commitment of the patient and their parents (in the case of children).

We believe that effective communication between the optometrist, therapist and patient is the best policy to follow.

What type of problems can be treated with Vision Therapy?

Practically all non-pathological visual disorders, such as:

  • Amblyopia (lazy eye).
  • Accommodative problems.
  • Binocular vision problems such as strabismus or suppressions.
  • Progressive myopias.
  • Learning and visual perception problems.
  • Visual fatigue and problems of concentration.