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Vision and Learning

Vision is a core component of the process of reading and learning. Certain vision problems are particularly prevalent and can contribute to a child’s reading difficulties. 

Any child facing difficulties in reading, or who reads competently but reluctantly, or who reads less accurately than would be expected from their other abilities, ought to consult a specialist in vision.

Reading involves a very wide range of cognitive skills, and visual-spatial difficulties are related to higher level visual function that is beyond the standard test of 20/20 vision. 

Nearly 50% of dyslexic children have some complaints about their vision, and this includes words ‘moving’, ‘shimmering’, ‘blurring’, ‘doubling’ or simply a general level of visual discomfort (‘asthenopia’). Sometimes, they may also report seeing distorted patterns and colours that are not actually there.

The symptoms can worsen whilst viewing a page of black text on a white background. The symptoms are often mild and some children fail to describe them, or may suppose that they are normal. There are also children who may complain about tired eyes, acute headaches and migraines. These symptoms can interfere with reading and learning.

Most often, the symptoms are not related to an eye disease, but the problem may be in the functional aspects of their vision or visual perception. These problems are measurable through optometric evaluations of visual efficiency, and they are not due to a psychological reason.

Teachers, medical doctors, allied health professionals, and caregivers all play a part in picking up these subtle tell-tale signs of potential vision problems in children. Mild symptoms arising from the conditions may slow down reading and may also discourage children from prolonged reading. 

Even good readers and those with ‘mild’ learning difficulties can also unknowingly suffer from vision problems. In the run-up to school exams, they may complain of headaches, eyestrain or discomfort when coping with a large amount of reading.

Further information: 

Article on Dyslexia and Vision: Current Evidence and Clinical Interventions (Published by Medical Grapevine Asia)

Past event on "Vision and Learning" (2012): Prof Bruce Evans (City University London and U.K. Institute of Optometry), Yap Tiong Peng (IGARD Group Singapore) and Christine Fitzmaurice (International Institute of Colorimetry) presented on the topic "Vision and Learning" under the invitation from the People's Association. This seminar was supported by the Distinguished Universities Alumni League and was well attended by Educationists, Psychologists, Occupational Therapists, Medical Doctors and parents. 

"When Bad Eyesight Causes Bad Grades" -- newspaper article featuring a patient from IGARD: http://www.tnp.sg/lifestyle/health/when-bad-eyesight-causes-bad-grades

Research publications:

https://www.ncbi.nlm.nih.gov/m/pubmed/28599912/
Efficacy of vision therapy in children with learning disability and associated binocular vision anomalies.
Hussaindeen JR, et al. J Optom. 2017.
Show full citation
Abstract

PURPOSE: To report the frequency of binocular vision (BV) anomalies in children with specific learning disorders (SLD) and to assess the efficacy of vision therapy (VT) in children with a non-strabismic binocular vision anomaly (NSBVA).

METHODS: The study was carried out at a centre for learning disability (LD). Comprehensive eye examination and binocular vision assessment was carried out for 94 children (mean (SD) age: 15 (2.2) years) diagnosed with specific learning disorder. BV assessment was done for children with best corrected visual acuity of ≥6/9 - N6, cooperative for examination and free from any ocular pathology. For children with a diagnosis of NSBVA (n=46), 24 children were randomized to VT and no intervention was provided to the other 22 children who served as experimental controls. At the end of 10 sessions of vision therapy, BV assessment was performed for both the intervention and non-intervention groups.

RESULTS: Binocular vision anomalies were found in 59 children (62.8%) among which 22% (n=13) had strabismic binocular vision anomalies (SBVA) and 78% (n=46) had a NSBVA. Accommodative infacility (AIF) was the commonest of the NSBVA and found in 67%, followed by convergence insufficiency (CI) in 25%. Post-vision therapy, the intervention group showed significant improvement in all the BV parameters (Wilcoxon signed rank test, p<0.05) except negative fusional vergence.

CONCLUSION: Children with specific learning disorders have a high frequency of binocular vision disorders and vision therapy plays a significant role in improving the BV parameters. Children with SLD should be screened for BV anomalies as it could potentially be an added hindrance to the reading difficulty in this special population.

End

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