Vision and ADHD – The Missing Link in Treating the Whole Patient
By Jesse Willingham, O.D.
There are two growing trends in the quality of health care patients are seeking – Precision Medicine, in which treatments are individually tailored to the patient, and Holistic Care, in which treatment considers not just individual diagnoses and specific bodily systems, but the whole physical, mental, and spiritual person. This should be no different in the diagnosis and management of attention problems, both in children and adults.
Here is one of my favorite statistics to share with parents of children diagnosed with ADHD: children diagnosed with ADHD are 3x as likely as other children to also have Convergence Insufficiency, a functional vision problem that can affect reading and attention. Conversely, children diagnosed with Convergence Insufficiency are 3x as likely to be diagnosed with ADHD!
Yet parents who receive a recommendation to treat their child for ADHD are rarely, if ever, recommended to get an eye exam first, and even when parents do take their children for an eye exam, they are often told the children’s eyes are normal. This isn’t surprising, because children with convergence insufficiency typically do have normal eyes!
The key is they have abnormal vision.
Having healthy eyes and 20/20 is the minimum standard to “pass” an eye exam in most locations, and this will be sufficient for a large part of the population. But for any patient with learning problems, there are over a dozen other visual skills that should be carefully looked at.
20/20 visual acuity describes your ability to see a certain level of fine detail in one slice of time. But vision is dynamic, and good vision allows for both maintained attention and seamless transition between targets, all while keeping two separate eyeballs pointed in the same direction. It only takes a little bit of thought and empathy to imagine that difficulty maintaining clear, single, comfortable vision can impact your ability to pay attention in school. The key difference between a visual dysfunction and attention deficit is that visual dysfunction can be improved without medication.
Every parent concerned about their children’s reading and learning should see a vision specialist like a developmental optometrist, but many eye doctors do not have a clinic set up in a way to delve into a full functional vision exam. This is understandable – you wouldn’t expect your primary care doctor to provide specialist care either, only to detect the problem and help coordinate care with a specialist. If your child is having reading and learning difficulties, schedule an evaluation with an optometrist specializing in functional vision disorders (the covd.org locate a doctor tool is a great place to start), or if you have a family eye doctor that doesn’t specialize in this area, ask them to help you coordinate care with a specialist.
At Brighter Outlook Vision, we help improve people’s vision so they can more fully engage in their life. If you have a child struggling to read, it could be a vision problem that could be corrected with vision therapy. We can also help young athlete’s improve their vision and speed up their reaction times. Learn more about who we can help or give us a call at 843-203-0200 and we can hear what you are dealing with to see if vision could be at the root of the problem.
