Benjamin Winters 0

Sanet/Vergara Protocol for Anisometropic Amblyopia

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VTODs I need your help. Please sign this petition. My hope is that if I get enough signatures, COPE will see that what I'm presenting is not that controversial. I'm trying to get our new 201 course COPE approved. The problem is that I have a reviewer that I believe is anti-vision therapy (even though the Sanet/Vergara protocol is predominantly lenses only). The reviewer has a problem with me teaching the Sanet/Vergara protocol for treating anisometripic amblyopia. He/She insists that I teach that you must use the PEDIG standardized protocols first. This doesn't even make sense, because part of PEDIG research shows that lenses only is an effective approach. The reviewer is saying that the Sanet/Vergara protocol is not evidence based. So, below is my appeal that they still rejected unless I change the course. If you want to see the part of my outline in question go to page 4 of the outline here.

  1. A previous reviewer passed the exact same outline without comment when the outline was submitted as a combined course with other courses.
  2. The Sanet/Vergara method for treating amblyopia is not taught in the course as being opposed to the PEDIG research. In fact, the PEDIG research and its subsequent treatment protocol is presented first in the course and shows in the outline that it is the gold standard for prospective randomized controlled research.
  3. The Sanet/Vergara method is really just a variation on one of the treatment protocols proposed by the PEDIG research for anisometropic amblyopia, which is a lenses only approach.
  4. The course does not teach the Sanet/Vergara method as being in opposition to the PEDIG method. Rather, if the Sanet Vergara method is not successful at treating the amblyopia (which a clinician would know in a period of 12 weeks), then the practitioner would logically then use a patching protocol as described in the PEDIG research.
  5. There is no harm that can be done to a patient by using the Sanet/Vergara method
  6. After reading the requirements of COPE there is nothing that requires randomized controlled trials as the basis for teaching treatment protocols. COPE defines a course as "A structured, educational session/intervention specifically designed to impart new knowledge, shared experiences or factual evidence, which is used to maintain the level of optometric competence consistent with the statutory requirements of a given state law. The Sanet/Vergara method would be considered to be a shared experience. Additionally, as described in my previous email, while the Sanet/Vergara method is not based on a randomized controlled study, it is based on Level VI research evidence (Evidence from a single descriptive or qualitative study) which is NOT the lowest level of research evidence. The Sanet/Vergara method is clearly discussed as being from the clinical experience of these clinicians and not from a higher level of research basis.
  7. I've attended COPE approved courses from well respected lecturers that have shared the clinicians personal clinical experience as the rationale for a given treatment protocol. As long as it is shared in this context and not misrepresented as being a protocol from a higher level or research evidence, I think this kind of clinical insight is very valuable at furthering our profession.

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