Editor’s Perspective

Overcome Your Reptilian Brain

Feb. 4, 2020

By Dwight Akerman, OD, MBA, FAAO
Chief Medical Editor, Review of Myopia Management

To change, we must overcome our reptilian brain. It’s a neurological fact that when new opportunities arise, when difficult decisions must be made, and when change is necessary, it is your reptilian brain that holds you back. It has been like this for millions of years. That’s why change is difficult.

Your brain consists of three different parts. There is your reptilian brain, the oldest part from an evolution perspective, the limbic brain, and the neocortex. Together these three brains are called the triune brain model, a term coined by Paul MacLean, MD.

The reptilian brain is the part of your brain that deals with essential bodily functions. The reptilian brain evolved to serve fundamental needs such as feeding, survival, mating, and self-maintenance. If you’ve noticed that people seem to have an initial reaction of disdain for change, it’s because of this part of your brain. We might not be living in the same world as primitive man, but we are still faced with threatening and unfamiliar situations. Familiar things are usually seen as safe and preferable, while unfamiliar situations are treated with suspicion until we have assessed them and the context in which they appear. Fortunately, the limbic brain, i.e., the emotional brain, and the neocortex, i.e., the thinking brain, can counterbalance the primitive instincts of the reptilian brain.

Myopia management is a threat to many eye care professionals because it is unfamiliar. Incorporating it into a primary care practice will require changing clinical protocols, modifying appointment schedules, updating fee schedules, adding new equipment, and retraining staff. When faced with a juvenile-onset progressive myope, most eye care practitioners play it safe, add another-0.50 DS to the child’s prescription, and tell the parents to bring the child back in one year for another eye exam. Nothing is prescribed to slow the progression of myopia.

You either control your reptilian brain or your reptilian brain controls you. As eye care professionals, we are not trained to provide sub-optimal care to children. Myopia is not a benign condition, so we must be all in with myopia management, challenging ourselves to stay ahead of the curve for the sake of our children’s vision and eye health.

Get proactive about childhood myopia care. It’s our professional responsibility.

Best professional regards,

Dwight H. Akerman, OD, MBA, FAAO
Chief Medical Editor

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