Conditions

LEARNING-RELATED VISION DISORDERS

As vision and learning are intimately connected, vision problems are often easily mistaken for learning problems. A learning-related visual problem directly affects how we learn, read, or sustain close work. Visual problems in any of the following areas can have a significant impact on learning:

• Eye tracking skills – eyes following a line of print
• Convergence (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 (from board to desk)
• Visual-motor integration – eye-hand coordination (writing)
• Visual perception – visual discrimination, visual and sequential memory, form constancy, spatial relationships, figure-ground, and closure

Though some school districts may conduct a developmental screening before children enter school, these screenings generally do not explore visual information processing as extensively as needed. Most school vision screenings only assess distance visual acuity, which is extremely inadequate in detecting learning related vision problems.

Many children have mild learning problems that are not of enough magnitude to be classified formally as a learning disability. However, they still may have significant learning related vision problems. In pre-school through 2nd grade, academic instruction places more demand on a child’s visual information processing skills, emphasizing recognition, matching, and recall. Periods of sustained near work are usually shorter and less frequent, and letters and numbers are large and widely spaced. Visual efficiency and processing speed become more significant by the 3rd/4th grade, with the need to achieve faster rates of fluent reading over longer periods of time, and with smaller and more closely spaced text. This is often when parents and teachers notice that a child is struggling in school.

Refer to our Symptoms Checklist to see if your child may be experiencing learning-related vision problems.

ADHD
AUTISM SPECTRUM DISORDER
STRABISMUS/AMBLYOPIA
CONVERGENCE INSUFFICIENCY (CI)
CONCUSSION / TBI
SPORTS ENHANCEMENT THERAPY

ADHD

Some children with learning difficulties exhibit specific behaviors of impulsivity, hyperactivity, and/or distractibility. A common term used to describe children who exhibit such behaviors is Attention Deficit Hyperactivity Disorder (ADHD). Undetected and untreated vision problems can elicit some of the very same signs and symptoms that are commonly attributed to ADHD. Due to these similarities, some children with vision problems are mislabeled as having ADHD. There is over 50 years of scientific evidence published in optometry, medicine and neuroscience in the US and internationally that shows a direct connection between developmental vision problems having a causative relationship to ADHD. If your child has been diagnosed with ADHD, or you suspect your child has ADHD, consider a functional vision evaluation to rule out a vision dysfunction. Stimulant medications and the side-effects that go with them may be avoidable.

AUTISM SPECTRUM DISORDER

Many parents and teachers struggle looking for answers for children on the autism spectrum. Because children with autism have a wide array of symptoms, the vision system is often overlooked. Those on the spectrum often use visual information inefficiently, have problems coordinating their central and peripheral vision, and have difficulty maintaining visual attention. Eye movement disorders and crossed eyes are common in the autistic spectrum. Autistic individuals can also ignore peripheral vision and remain fixated 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, resulting in motor, cognitive, speech, and perceptual dysfunction.

Visual symptoms highly associated with ASD
• Gaze aversion
• Turning head, looking out of corner of eye
• Being attracted to shiny surfaces or mirrors
• Prolonged fixating on light patterns, windows or blinds
• Hyperfixating on one object while ignoring other objects in the room
• Prefers/avoids a particular color
• Shows distorted body postures or orientation, including arching back, hyperextension of neck
• Toe walking
• Touches all surfaces (walls, furniture, etc) when in an unfamiliar environment
• Anxiety or avoidance associated with fast moving objects or animals
• Spinning objects close to face
• Flicking fingers or hands near face
• Stares at nothing with no apparent purpose
• Excessive interest limited to a single toy
• Intense light sensitivity
• Poor attention to one’s surroundings as well as a lack of interest in one’s environment
• Preference for looking at objects (or parts of objects) rather than people

from Understanding the Visual Symptoms of Individuals with (ASD)
related links:
Journal of the American Academy of Child and Adolescent Psychiatry and Research in Autism Spectrum Disorders
Autism Research Institute Melvin Kaplan OD
Autism: The Vision Connection | The Autism File
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STRABISMUS/AMBLYOPIA

Strabismus is a visual problem in which the eyes are not aligned properly. One eye may look straight ahead, while the other eye turns inward, outward, upward, or downward. The eye turn may be consistent, or it may alternate. It is estimated that up to 5 percent of all children have some type or degree of strabismus. It may run in families, and it can also occur later in life.

To line up and focus both eyes on a single target, all the muscles in each eye must be balanced and working together. In order for the eyes to move together, the muscles in both eyes must be coordinated. The brain controls these muscles. For normal vision, both eyes must aim precisely at the same spot. The brain then combines the two pictures into a single, three-dimensional image, which gives us depth perception. When one eye is out of alignment, two different pictures are sent to the brain. To avoid seeing double, vision in one eye may be ignored, resulting in amblyopia. An optometrist should examine any child older than 4 months whose eyes do not appear to be straight all the time. Strabismus in children does not go away on its own and strabismus in adults is treatable.

Amblyopia is a developmental disorder of spatial vision characterized by reduced visual acuity and visual information processing. The signs/symptoms of amblyopia include reduced vision in one or both eyes, spatial distortion, reduced stereopsis, reduced accommodative facility, and inefficient ocular motor skills. This vision loss occurs because nerve pathways between the brain and the eye aren’t properly stimulated. The brain “learns” to see only blurry images with the amblyopic eye even when glasses are used. The term “lazy eye” was a loosely used medical term that described this common cause of visual impairment in approximately 5% of U.S. children. It’s not an eye problem, it’s a problem where the brain ignores visual images from the amblyopic eye. The eye is not “lazy”, the brain is simply eliminating conflicting visual information by ignoring one of the images. Early detection and intervention maximizes the success in the treatment of amblyopia.

American Optometric Association
https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/strabismus?sso=y

Optometrist’s Network
https://www.strabismus.org/

COVD
https://www.covd.org/?page=Strabismus
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CONVERGENCE INSUFFICIENCY (CI)

Due to recent scientific research, Convergence insufficiency, the most common type of binocular disorder, has been gaining public recognition. When you read or look at a close object, your eyes turn inward (converge) to focus, enabling you to see a single image. CI occurs when your eyes don’t work together to converge on a nearby object, and is the leading cause of eyestrain, blurred vision, double vision, and headaches. This common condition causes difficulty with reading, often causing parents or teachers to suspect that a child has an attention or learning problem, instead of an eye disorder. A person can pass the 20/20 eye chart test and still have convergence insufficiency.

CONCUSSION / TBI

A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. The effects of a concussion can be serious. Signs and symptoms generally show up soon after the injury, however, some symptoms may not show up for hours or days.
Because there is a close relationship between vision and the brain, traumatic brain injury, including concussions and sports-related head injury can disrupt the visual process, interfering with the flow and processing of information. Concussions can result in accommodative insufficiency, blurred vision, convergence insufficiency, double vision, light sensitivity, ocular-motor dysfunction, reduced cognitive ability with visual tasks, and reduced visual processing speed or reaction time.

Although concussions may also occur outside of sports from things like accidents on playgrounds, baseline testing is especially important for children involved in any high-energy and contact sports such as football, gymnastics, cheerleading, soccer, hockey, skateboarding, basketball, and lacrosse. Recently many states, schools, and sports leagues and organizations have created policies or action plans on concussion in youth and high school sports. Any child can get aconcussion by simply jarring their head suddenly or falling on the ground. Given the many ways a child can get a concussion and the potential long-term risks, some parents may choose to do baseline testing for their children.

Dynamic Vision Therapy offers King-Devick baseline concussion testing. The K-D Test has been shown in published studies to detect even those un-witnessed or unreported concussions.

https://www.cdc.gov/headsup/pdfs/policy/headsuponconcussioninsportspolicies-a.pdf
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SPORTS ENHANCEMENT THERAPY

Many interrelated vision skills affect how well you play your sport. Vision therapy can help improve your visual fitness and accuracy.
Many sports involve a ball or a fast-moving opponent, and you need to be able to follow objects without much head motion. Eye tracking helps you maintain better balance and quickly react to the situation. Eye-hand-body coordination is how your hands, feet and body and other muscles respond to the information gathered through your eyes. It’s an important part of most sports as it affects both timing and body control. Visual concentration is the ability to selectively screen out distractions and stay focused on the object or the target. The athlete with good visual memory processes and remembers a fast-moving, complex picture of people and things, and always seems to be in the right place at the right time. Through visualization, you see yourself performing well in your “mind’s eye” while your eyes are concentrating on something else, usually the ball.When an athlete sees her teammate out of the corner of her eye, she is using her peripheral vision. Much of what happens in sports does not happen directly in front of you. Therefore, increasing your ability to see action to the side without having to turn your head is important. Increasing your visual reaction time improves the speed with which your brain interprets and reacts to your opponent’s action.Depth perception enables you to quickly and accurately judge the distance between yourself, the ball, your opponents, teammates, boundary lines and other objects. If you consistently over- or underestimate the distance to your target, poor depth perception may be the reason.

From https://www.aoa.org/patients-and-public/caring-for-your-vision/sports-and-vision/important-vision-skills-for-sports?sso=y
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CONDITIONS