Learning-Related Vision Problems

An estimated 25% of school-age children have learning-related vision problems. Students can have difficulties in any of a number of areas. Maybe their two eyes don’t work together to track or focus. These and other problems can have a profound effect on how they learn.

What Are Learning-Related Vision Problems?

Symptoms of vision problems include:

Eyes that are red or tear when stressed
Poor hand-eye coordination
Avoidance of academics
Decreased comprehension
Slow reading/writing
Losing place
Omitting words
Skipping lines
Confusion of similar words
Discomfort
Fatigue
Headaches
Short attention span when doing schoolwork

Vision Problems and/or Disabilities?

Because vision and learning are intimately connected, vision problems can be easily mistaken for learning or attention problems. Undetected and untreated vision problems can elicit some of the very same signs and symptoms commonly attributed to:

ADD and ADHD
Autism
Sensory Processing Disorder
Learning disabilities
Dyslexia
Lyme disease
PANS/PANDAS
Impulsivity
Hyperactivity
Distractibility
Poor reading
Trouble learning math
Illegible handwriting

In some instances these conditions co-exist and treating one aspect of the problem masks the other.

Eyesight vs. Vision

Eyesight tells only how clear the image is. Vision is more than clarity. It is the brain’s ability to visualize, understand and apply the information that comes in through the eyes: the learned ability to give meaning to what is seen.

From birth, vision works together with the other senses to lay the foundation for cognition, behavior, personality and learning.

Convergence Insufficiency

David Granet, MD and researchers at the Children’s Eye Center, University of San Diego, uncovered a relationship between a common eye-teaming problem called convergence insufficiency and ADHD. In convergence insufficiency, the eyes tend to drift outward when a person is reading or doing close work. When eyes drift out, a person may have double vision.

To prevent seeing double, an individual attempts to make the eyes turn back in or converge, which then interferes with the ability to read and work comfortably at near distances. In the above study, children with convergence insufficiency were three times as likely to be diagnosed with ADHD as children without the disorder.

Does convergence insufficiency make ADHD worse, or is convergence insufficiency misdiagnosed as ADHD? In either case, patients diagnosed with ADHD should be evaluated for convergence insufficiency and treated accordingly.

Visual Function and Autism

Most individuals diagnosed with autism use visual information inefficiently. They frequently have difficulty maintaining visual attention, have eye movement disorders and have eye-teaming problems.

Some of the hallmark behaviors of autism are signs of vision problems:

Poor eye contact
Staring at spinning objects or lights
Side viewing
Difficulty paying attention

Individuals with autism also often have problems coordinating their central and peripheral vision, ignoring peripheral vision, and fixating on a central point of focus for excessive periods of time.

Poor integration of central and peripheral vision can lead to difficulties in processing and integrating visual information. Motor, cognitive, speech, and perceptual abilities can also be affected when visual processing is interrupted.

A Comprehensive Vision Exam

When children are struggling, a thorough exam including the following is imperative:

A complete developmental and health history
A measurement of how clearly the patient can see at a distance and up close: nearsightedness, farsightedness, or astigmatism
An assessment of eye focusing, eye teaming, and eye movement abilities (accommodation, binocular vision, ocular motility)
An examination of the health of the eyes

Methods for evaluating the vision of non-verbal individuals vary depending upon levels of emotional and physical development. Many developmental optometrists are experienced in examining people with autism, learning disabilities and other developmental delays.

Patients are sometimes asked to perform specific activities while wearing special lenses. The doctor observes any postural adaptations and compensations the patient makes when sitting, walking, standing, or catching and throwing a ball.

Such tests help to determine how well a patient is using vision, and what can be done to improve performance. Following complete testing, the doctor reviews all findings with the patient and/or parent and provides consultation and recommendations regarding any needed treatment.

Treatment of Learning-Related Vision Problems

Depending on the results of testing, a developmental/behavioral optometrist may prescribe glasses to help the patient compensate for nearsightedness, farsightedness, astigmatism or other problems. He/she might also recommend a program of vision therapy to:

Increase visual arousal
Organize visual space
Improve eye movements
Gain more efficient eye coordination
Enhance other important visual abilities

Individualized goals are directed toward resolving underlying visual problems that interfere with reading, learning, and behavior, as vision therapy is not an independent treatment for learning disabilities, attention deficit disorder or autism.