Vision Problems that Interfere with Learning
Is it a learning disability or a correctable vision problem? With school being 80% visual learning, the importance of vision cannot be overstated, both academically and emotionally!
Anna Warren, Vision Therapist
Many people think that healthy vision is just the ability to see clearly, but vision is not just about seeing 20/20. Seeing 20/20 is actually only one step in more than a dozen skills needed for effective visual processing and learning. Someone can have normal 20/20 vision, but still have a vision related learning problem. You most likely know someone suffering from this as 1 in 10 children have a vision problem severe enough to impact their learning.
The process of learning is defined as an individual’s ability to derive meaning from what is experienced, establish a relationship to what is already known (because in learning we build on what is already known), and to develop a memory from that experience for new information and relationship. Good vision is imperative to being a good learner.
If someone is said to have a learning disability, it means that their performance does not meet their intelligence. It could be that a child’s vision is what is affecting their performance and if found and helped, can be fixed.
Vision and Learning Connection
The topic of vision and learning may be the most important part of vision care. Eyes lead the way in visual learning, as studies show that 80% of what kids are learning in the classrooms comes from the visual system. Eyes are the first point of input. Once eyes detect light, it is the visual pathways to and from the brain and the eyes that result in learning. By evaluating the eyes and these pathways to the brain, we can detect where vision and learning difficulties are.
How Vision Works
2/3rds of all the nerves that enter the brain come from the eyes. In optometric vision therapy, we can modify the way that light enters the eye via prisms, lenses, and filters to give optimal input into that eye, which can be very supportive in visual learning. Doing this in therapy creates new pathways to the brain that give way to more efficient vision, which leads to easier learning.
It’s what happens after the eyes detect the light and with the pathways to the brain that direct vision- the eyes coordinating or teaming with one another (binocularity), and moving from one word to the next on a page to gather the information in a sequential array (saccadic eye movements). Saccadic eye movements and binocularity are visual skills that allow for a more organized way of gathering visual information. However, people with visual impairments may not be able to control their saccadic eye movements or make the two eyes work together. This prevents them from being able to see the page in an organized way as their eyes are not able to move synchronously across a page which can reduce their ability to integrate information and develop those pathways for learning.
Specific Vision Problems
Vision problems is an overarching term that includes several diagnoses. The most common problem children have is Convergence Insufficiency (CI): disorder of eye teaming that can cause the brain to be preoccupied and distracted with the mechanics of reading (eye movements across the page to each word). Between 4-17% of the US population have CI. People with CI cannot point their eyes at a near target which results in double vision when reading or doing any near work. When eye coordination is not working automatically like it should, it takes extra thought and concentration which depletes the brain’s ability to comprehend and learn.
Children usually don’t know they have a vision problem because they think that is how everyone sees. They have never known anything different. If they do report it, most of the time they aren’t able to use appropriate terms and so are not believed. For them, reading is “hard,” since they don’t have the vocabulary to say what is happening when they try to read a book and the words move on the page or they can’t easily find their place again. They are often just told to try harder or pay attention, but their visual system is already overloaded and they are trying as hard as they physically can.
The following are a few of the vision problems that can cause difficulty reading, learning, and paying attention:
Binocular vision problems
Vision occurs when the eyes send signals to the brain. Usually the brain receives information from both (bi) eyes (ocular). The eyes transmit different information, and healthy eyes will help the brain judge distances, depth perception, speed of objects, and coordinate eye movements. You can see how much both eyes help you by closing one eye and trying to pour a glass of water or trying to touch two pen caps together.
Diagnoses: convergence insufficiency, convergence excess, exophoria, esophoria, etc.
How this may look: Tired or sore eyes, children may say they are tired after a long day of near work. Blurry vision or double vision, children may not like reading because it is physically intensive. Headaches. Trouble concentrating, children with ADHD are 3x more likely to have convergence insufficiency. May also avoid homework or other near work.
How does vision therapy help? Vision therapy teaches the eyes to work together. It changes how the brain coordinates the eyes to make binocular vision more efficient and effortless.
Visual tracking is the eye’s ability to move, either in large movements like seeing a ball go across the sky or small movements like tracking from word to word on the page. In general, this refers to the ability to quickly and accurately look (fixate), visually follow a moving object (pursuit), and efficiently move our eyes so we can fixate on objects from point to point as in reading (saccades). Good tracking is essential for reading. The eyes have strong muscles to move them around, but the brain directs that movement. If the brain struggle to find its place, then the eyes will jump around as demonstrated below.
Diagnosis: oculomotor dysfunction
How this may look: Reluctance or avoiding reading. Poor reading comprehension; a child may read, but then have no idea what it was about when questioned. Frequently rereads the same word, may use their fingers to track where they are when reading. Skips over words or entire lines of text, often reads small words backwards (“was” for “saw”, or confuses b’s and d’s).
How does vision therapy help? Vision therapy creates new neural pathways that improves fixation and saccadic movements, integrates oculomotor skills with vergence accommodative systems, and with information processing, and enhances visual information processing and spatial awareness to better guide ocular movements.
Eye focusing problems
The eye needs to be able to change focus, from looking up close to far away, like looking from a desk to the whiteboard. This happens by the lens changing shape, somewhat similarly to a camera focusing in. Accommodation is the adjustment of the optics of the eye to keep an object in focus on the retina as its distance from the eye varies. For some people it takes longer and more attention to make things come into focus, which can hold them back.
Diagnoses: accommodative insufficiency, accommodative excess, accommodative infacility
How this may look: Headaches, eyestrain, up close vision that is blurry or goes in and out of focus, reluctance to read or avoiding reading, visual fatigue, sleepiness, poor reading comprehension.
How does vision therapy help? Builds accuracy, flexibility, and sustainability of accommodation. Teaches the eyes how to focus properly in coordination with eye teaming.
Every child who is having trouble reading deserves comprehensive, multi-faceted consideration.
They should begin with visual testing because most testing that will follow uses the visual system. If you are already having trouble seeing, you will by default have trouble seeing the psycho-educational tests, where they are looking at school achievement or IQ. A child’s speech and hearing should also be tested. Dietary issues could also be a factor.
There are lots of things that can impact a child’s ability to read, but the impact of the visual system can be profound. Many children don’t need to continue struggling or working harder than they need to, their skills can be improved through optometric vision therapy. Being a good reader and having good vision goes beyond seeing 20/20, but if you haven’t learned the necessary skills, there is help available.
If you know someone who is having a problem, they should be tested by a developmental optometrist to ensure they are utilizing their vision to the best of their abilities. You can find a developmental optometrist through the College of Optometrists in Vision Development’s locate a doctor site. If you are in the Charleston area, Brighter Outlook Vision is happy to help.