Vision problems in children, other than simple refractive errors such as nearsightedness, farsightedness, and astigmatism are not uncommon. These issues can cause significant behavioral and learning challenges for children.

Often, these challenges manifest in ways that are often confused with 

• Dyslexia
• ADD
• ADHD
• Reading Problems
• Poor focus
• Amblyopia (“lazy eye”)
• Eye Alignment
• Visual Perceptual Disorders

and can result in misdiagnosis, all requiring vision therapy. If children exhibiting these symptoms receive a negative diagnosis, left untreated, these non-refractive vision problems can cause learning problems, fatigue, eyestrain, and headaches. If you are concerned about your student or child, schedule a developmental eye exam with our optometrist and Vision Therapy doctor today! 

Most people are familiar with vision problems that eyeglasses address; nearsightedness, farsightedness, and astigmatism. These are called refractive conditions.

A learning-related visual problem directly affects how we learn, read, or sustain close work. Because difficulties with reading and learning affect the child's ability to focus, vision-related learning problems are often misdiagnosed as ADHD or other behavioral issues.

Visual problems in any of the following areas can have a significant impact on learning:

• eye tracking skills - eyes following a line of print
• eye teaming skills - two eyes working together as a synchronized team
• binocular vision - simultaneously blending the images from both eyes into one image
• accommodation - eye focusing
• visual-motor integration - eye-hand coordination
• visual perception - visual memory, visual form perception, and visualization

Vision and learning are intimately connected.  Someone may have a learning problem that is caused by an underlying vision problem. A child with a vision problem can be misdiagnosed as having Learning Disabilities, ADHD, or Dyslexia. There are various reasons for this misdiagnosis. For example, children who have learning-related visual problems cannot sustain their close work at school or home and often show signs of Inattention or Hyperactivity. A child may be misdiagnosed with ADD or ADHD because children with ADHD also can't sustain attention on their work, and inattention and hyperactivity are the two of the three main symptoms for the diagnosis. Same behaviors with vastly different diagnoses.

Attention Deficit Disorder (ADD) is a widespread problem. If a child has a short attention span, the common assumption is that the child has ADD and should be on medication. If a child has behavior problems, then the assumption is that they have ADHD, Attention Deficit Hyperactivity Disorder.

At times, an underlying vision problem further complicates matters. Addressing the vision problems reduces the symptoms of ADD and sometimes eliminates them entirely.

If a child has difficulty pointing their eyes in to read material (convergence), if they can’t physically focus (as you would focus a camera), or if they can’t sustain those activities, that makes it all the more difficult for the individual to maintain sustained attention. More energy is needed for the visual system and there is then less energy to concentrate on reading. This then leads to a short attention span. If someone can’t physically maintain concentrating for whatever reason, they may be then labeled ADD.

A child who cannot focus because of a vision problem will not be able to sit still and do as instructed. Furthermore, a child with these kinds of vision problems is not able to direct their eyes and focus within the amount of time allotted to complete assigned tasks and homework. In this case, medication will not be effective. As the child develops the visual ability to correctly physically focus their eyes, they are better able to attend and concentrate, maintaining their mental focus for longer periods. They are then able to complete their work.

Before a diagnosis of ADD/ADHD is made, (or even once it has been made) and medications prescribed, parents and teachers should first consider a comprehensive eye examination with our developmental optometrists for their children. Much is at stake in the event of a misdiagnosis.

For more information on ADD and the connection with Convergence Insufficiency please see https://www.ncbi.nlm.nih.gov/pubmed/16361187

There is no consensus on the official definition of dyslexia. Often referred to as a “learning disorder”, dyslexia is typified with difficulty reading or interpreting symbols in the correct order or syntax despite the fact that the person with dyslexia has, at least, average intelligence. "Dys" means "not". "Lex" means "read". Dyslexia, therefore, literally means not being able to read.

A substantial number of individuals with dyslexia actually have other visual problems that make the problem greater. All too often, an undiagnosed vision problem is the reason the individual was diagnosed as having Dyslexia in the first place.  If a vision problem affects learning, it can sometimes be misidentified as dyslexia because there are striking similarities between the two.

Vision Therapy Treatment For Dyslexia

Behavioral and Developmental Optometrists at the Bolton Vision Therapy Centre in Bolton, Southern Ontario have the knowledge and experience to diagnose and treat vision disorders that masquerade as Dyslexia or contribute to the unique challenges presented by Dyslexia. However, Vision Therapy does not treat Dyslexia itself.

Special needs such as autism, cerebral palsy, down syndrome, and other conditions often mean a child struggles with hand-eye-coordination. Children with these challenges, or anything else requiring occupational therapy, is very likely to gain immensely from Vision Therapy. A regimen of customized focus and perception exercises will improve depth perception and fine motor skills.

• 45% of patients with down syndrome have strabismus/cross-eye
• As many as 40% of autistic people have strabismus/cross-eye
• Estimates of the incidence of strabismus in children with cerebral palsy go as high as 88%, Vision Therapy has shown to be effective for children with cerebral palsy.

Vision problems are very common in individuals with developmental disabilities such as autism. These problems or stims include:

• lack of eye contact
• staring at spinning objects or light
• fleeting peripheral glances
• side viewing
• difficulty at maintaining visual attention

People with autism and other developmental disabilities often have trouble efficiently and accurately processing visual information, often combined with difficulty coordinating between peripheral and central vision. Following an object (eye-tracking) is also a typical problem. There is usually a preference to scan or glance at objects from the side instead of looking at them straight on. Eye movement disorders and crossed eyes are common in the autistic spectrum.

Vision Therapy is effective at stimulating and improving proper visual responses, eye movements, and the central visual system. Vision Therapy is also effective in helping patients to better organize visual space and gain peripheral stability so that he or she can better attend to and appreciate central vision and gain more efficient eye coordination and visual information processing. Dr. Dr. Donati, Dr. McKenzie, and Dr. Wiebe is certified as a Fellow of the College of Optometrists in Vision Development (COVD) and is experienced in examining and treating individuals with developmental disabilities and autism, even those who are non-verbal.

Patients with Down Syndrome overwhelmingly require eye care, with 70% requiring glasses. 45% of people with down syndrome have strabismus, which is usually best treated by a Vision Therapy Optometrist. Furthermore, there are a variety of ocular diseases associated with Down Syndrome patients such as tear duct abnormalities that can lead to severe discomfort, keratoconus (misshapen cornea) and congenital cataracts. A patient with Down syndrome may also require specialized glasses made for their unique facial features.

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Patients with Cerebral Palsy will most likely have visual conditions that require correction with glasses and in many cases Vision Therapy. Recent research on Vision Therapy for Cerebral Palsy is showing that it is extremely effective. Many patients with Cerebral Palsy will have Strabismus, or, “crossed eyes”, which is most effectively treated with a Vision Therapy program that is personalized to the patient.

Links to further research

https://www.aaopt.org/detail/knowledge-base-article/vision-therapy-effective-treating-visual-skills-patient-cerebral-palsy

http://www.ovpjournal.org/uploads/2/3/8/9/23898265/ovp3-5_article_kress_web.pdf