We learn to use the visual process over time. Visual abilities develop as a result of life experiences that children have prior to entering school. We are a product of the environment we grow up in. Many of the skills and abilities we have began with meaningful life experiences as children. Visual skills and abilities are learned primarily through movement and interaction with our three-dimensional world. Novelty is critical for the emergence of a diverse set of skills and abilities.
A child with a limited set of experiences should not be expected to acquire skill merely as a result of surviving a certain number of years on this earth. Time alone does not cause development. Good development is the result of the appropriate meaningful experiences occurring at opportune times in a person’s life. Physiological maturity alone is not sufficient to guarantee proper development.
We cannot expect children who have never heard classical music to identify an oboe or a trumpet by their distinctive sounds. To do so they need the life experience of listening to these instruments in isolation and having someone properly identify the instruments for them. This needs to be repeated more than once to become a lasting skill.
Learning how to fixate on an object, shift visual attention from one point in the visual array to another, precisely align both eyes with ease for sustained periods of time, and shift attention from distance to near and back again are all developed skills. A child who has not had appropriate life experiences in meaningful ways may come to school without these requisite skills.
A behavioral optometric evaluation can be compared to taking an inventory of these visual abilities and skills and finding which are present and which may not yet have emerged. The lack of the emergence of these visual abilities no more represents a physical or physiological or mental deficit than it does in the music example above. In this situation, no one would diagnose a neurological music processing brain center in need of medication. There would be recognition that the life experiences necessary had not been encountered. (Of course there are isolated instances of such problems but these are few and far between.) The vast majority of what we see in clinical practice are visual development problems.