Vision is learned. From our earliest moments in life we develop our ability to use sight to match up information with our movement system and other senses to organize, confirm, and develop experience. This is vision.
The experience of vision should become the primary means by which the child or adult explores his environment. Vision also becomes a primary influence in higher functions such as attention and concentration.
A Behavioral Vision Examination is a comprehensive evaluation during which the doctor analyzes not only functional vision problems (e.g. problems with eye muscle coordination), but also visual processing problems that affect our ability to attend, concentrate, orient ourselves in our spatial world, and organize movement. A Behavioral Vision Exam differs from a routine eye exam in that the doctor will spend additional time analyzing vision behaviors to gain more information about visual imbalances.
How Vision Affects Learning
Children often have vision problems that interfere with learning abilities in the classroom. Frequently the vision problems are not diagnosed even following normal eye examinations and vision screenings at school or in doctors’ offices. Vision problems interfere with and challenge the ability to attend and concentrate. When vision problems are severe they can affect perceptual abilities and can even cause developmental delays.
Functional and/or developmental vision problems can cause interference with teaming of the two eyes. This can cause children to have difficulty maintaining their eyes in alignment, particularly when reading and writing. Focusing problems can also interfere with a child’s ability to sustain visual attention during reading and writing activities.
Vision screenings in school systems often do not evaluate the functional use of eyes for reading and writing activities. Most vision screenings in schools test the child’s visual acuity at 20 feet. Children may have 20/20 acuity at distance but, as noted, may have difficulty maintaining their focus and alignment and thus may have blurred vision when looking at close printed or written material. Some children will even have double vision at close viewing distances but will be able to pass the vision screening for distance vision. While it makes little sense to only screen visual acuity at distance and then to send the child back to the classroom to work for the next several hours performing reading and writing tasks, this is presently the standard that is being used across the United States in our schools.
Doctors performing only standard eye examinations will frequently miss the functional vision problems affecting near vision. If only a standard eye examination is performed, the eye doctor will inform the parents that the child has healthy eyes and that the distance acuity is normal or 20/20. Unfortunately, the doctor will often not test for convergence or focusing abilities. However, these are the visual skills that when not functioning properly relate to the symptoms of eye strain, headaches, and may result in learning difficulties.
A vision examination should include a careful functional analysis of near vision skills including the ability to develop pursuit tracking, saccades (quick eye movements), and sustained focusing ability.
Below are listed some common symptoms of vision problems affecting learning ability. Children who have vision problems are frequently diagnosed with Learning Disabilities and/or Attention Deficit Disorder. It is important to understand that Learning Disabilities and Attention Deficit Disorder are classifications of symptoms and are not a cause in themselves. One of the main reasons for having LD or ADD can be vision problems that are undiagnosed and that cause the symptoms.
Common symptoms of functional vision problems affecting children in the classroom are as follows:
- Eyestrain after reading and/or writing
- Double vision
- Blurring of print
- Poor handwriting, clumsiness
- Seeing words jumble or move on the page Color
- Losing one’s place when reading
- Using a finger to keep the place when reading
- Lack of retention of written material
- Daydreaming or loss of attention and concentration
- Having to re-read a paragraph to understand it
- Blurring of vision at distance after reading
After a careful functional vision examination, treatment options may include glasses that relax the visual process enabling improved focusing ability and eye teaming or integration. Glasses may be recommended to be worn in school and for all reading and homework. Frequently parents and teachers as well as children will notice that reading and writing skills may improve from simply using these specially designed developmental lenses.
Another option that is sometimes considered is vision therapy. This is a special approach to train the child to establish improved visual skills necessary to meet the visual demands of reading and writing in the classroom. In vision therapy the doctor will present special activities using instruments, lenses, and prisms, to establish visual skills in order to improve visual function.
Dr. Padula has been specially trained to diagnose and treat vision problems affecting learning abilities of children. He received the E.B. Alexander Fellowship at the Gesell Institute of Child Development where he studied and treated developmental vision problems of children from infancy through school age. Dr. Padula has written many publications concerning vision problems of children and he has lectured extensively on the subject. To contact him, please click on this link.