For a long time vision has been taken for granted with relation to reading and learning. If a child or adult can see clearly, and has healthy eyes it is assumed that vision is not part of the problem. This can lead to missed diagnoses, and mis-diagnoses.
Vision problems can significantly impact reading and learning, particularly for children. Optometric Vision Therapy (OVT) offers evidence-based treatment designed to improve visual skills, including eye coordination, focus, and tracking, which are critical for reading and academic success. For children struggling with vision-related learning issues, including convergence insufficiency, optometric vision therapy can provide life-changing improvements.
Understanding Vision Therapy and Reading
Vision is more than just seeing clearly. It involves a complex process where the eyes and brain work together to process visual information. In children with learning difficulties, undiagnosed binocular vision problems such as convergence insufficiency (CI) or accommodative dysfunction can hinder their ability to focus, track, and process text effectively, leading to reading difficulties, headaches, and eye strain.
Research has shown that children with CI, a common binocular vision disorder, can experience significant improvements in reading performance through vision therapy. According to a study led by Scheiman et al. (2018), treatment for CI resulted in statistically significant improvements in reading comprehension and reading speed, as measured by the Gray Oral Reading Test .
How Vision Therapy Works
Vision therapy for reading and learning-related vision problems typically involves office-based exercises and treatments tailored to each individual’s needs. These exercises strengthen the eye muscles, improve coordination between the eyes, and enhance the brain’s ability to process visual information efficiently. Treatments focus on vergence (eye coordination), accommodative function (focusing), and oculomotor control (eye tracking).
A randomized clinical trial comparing treatments for CI found that office-based vergence accommodative therapy (OBVAT) was significantly more effective in improving symptoms than other home-based methods . This highlights the importance of professional, in-office care for achieving optimal results.
The Impact of Vision Therapy on Learning and Behavior
Vision problems don’t just affect academic performance; they can also impact a child’s behavior. A study by Borsting et al. (2012) found that children who received successful treatment for CI exhibited fewer academic behavior problems. Parents reported improvements in their child’s ability to focus on schoolwork and reduced concern over reading difficulties .
Additionally, vision therapy has been shown to reduce symptoms of ADHD and improve attention in children with visual disorders like CI. In a study by Lee et al. (2014), children undergoing vision therapy for CI showed improvements in ADHD-related behaviors as measured by the Korean ADHD Rating Scale (K-ARS) . This highlights the link between visual dysfunction and behavioral issues in children.
Evidence-Based Outcomes for Vision Therapy
Optometric Vision Therapy has garnered support through numerous studies, showing improvements in reading performance, academic behaviors, and overall vision function. From improved reading comprehension and speed to a reduction in behavioral problems, the evidence is clear that vision therapy can make a meaningful difference in the lives of children with vision-related learning difficulties.
Key Findings from Research:
- Reading Improvements: Scheiman et al. (2018) found significant increases in reading comprehension and speed in children treated for CI .
- Behavioral Benefits: Borsting et al. (2012) reported reductions in adverse academic behaviors after successful CI treatment .
- Attention and ADHD: Vision therapy has been linked to improved attention and reductions in ADHD symptoms .
Conclusion: Optometric Vision Therapy for Reading and Learning
Optometric Vision Therapy is a powerful, evidence-based solution for addressing vision problems that interfere with reading and learning. By enhancing the way the eyes and brain work together, this therapy can improve not only reading skills but also overall academic performance and behavior. For parents and educators, recognizing the signs of vision-related learning difficulties is crucial, and seeking an optometric assessment can be the first step toward unlocking a child’s potential.
Evidence Review
Effect of treatment of symptomatic convergence insufficiency on reading in children: a pilot study.
Scheiman M1, Chase C2, Borsting E3, Lynn Mitchell G4, Kulp MT4, Cotter SA3; CITT-RS Study Group.
Clin Exp Optom. 2018 Mar 25
Conclusion:
‘After treatment for convergence insufficiency, statistically significant improvements were found for reading comprehension (mean = 4.2, p = 0.009) and the reading composite score (mean = 2.4, p = 0.016) as measured by the Wechsler Individual Achievement Test at the 24-week visit. These improvements were related to the clinical treatment outcome measures (p = 0.011) with the largest improvements occurring in those who were early responders to treatment. Reading speed (words per minute) increased significantly on the Gray Oral Reading Test (p < 0.0001).’
Improvement in academic behaviors after successful treatment of convergence insufficiency.
Borsting E1, Mitchell GL, Kulp MT, Scheiman M, Amster DM, Cotter S, Coulter RA, Fecho G, Gallaway MF, Granet D, Hertle R, Rodena J, Yamada T; CITT Study Group.
Optom Vis Sci. 2012 Jan;89(1):12-8. doi: 10.1097/OPX.0b013e318238ffc3.
Conclusion:
‘A successful or improved outcome after CI treatment was associated with a reduction in the frequency of adverse academic behaviors and parental concern associated with reading and school work as reported by parents.’
Improvement of Vergence Movements by Vision Therapy Decreases K-ARS Scores of Symptomatic ADHD Children.
Lee SH1, Moon BY2, Cho HG2.
J Phys Ther Sci. 2014 Feb;26(2):223-7. doi: 10.1589/jpts.26.223. Epub 2014 Feb 28.
Conclusion: Convergence insufficiency symptoms are closely related to symptoms screened for ADHD, and vision therapy to improve vergence movements is an effective method of decreasing the K-ARS scores.
Behavioral and Emotional Problems Associated With Convergence Insufficiency in Children: An Open Trial.
Borsting E1, Mitchell GL2, Arnold LE2, Scheiman M3, Chase C4, Kulp M2, Cotter S5; CITT-RS Group.
J Atten Disord. 2016 Oct;20(10):836-44. doi: 10.1177/1087054713511528. Epub 2013 Nov 22
Conclusion: ‘In an open trial, attention and internalizing problems improved significantly following treatment for CI (Convergence Insufficiency).’
Randomized clinical trial of treatments for symptomatic convergence insufficiency in children.
Convergence Insufficiency Treatment Trial Study Group1.
Arch Ophthalmol. 2008 Oct;126(10):1336-49. doi: 10.1001/archopht.126.10.1336.
Conclusion: ‘Twelve weeks of OBVAT (office based vergence accommodative therapy) results in a significantly greater improvement in symptoms and clinical measures of near point of convergence and positive fusional vergence and a greater percentage of patients reaching the predetermined criteria of success compared with HBPP(home based pencil pushups), HBCVAT+ (home based computer vergence and accommodative vergence therapy), and OBPT (office based placebo therapy). Application to Clinical Practice Office-based vergence accommodative therapy is an effective treatment for children with symptomatic convergence insufficiency.’
Efficacy of vision therapy in children with learning disability and associated binocular vision anomalies.
Hussaindeen JR1, Shah P2, Ramani KK3, Ramanujan L4.
J Optom. 2018 Jan – Mar;11(1):40-48. doi: 10.1016/j.optom.2017.02.002. Epub 2017 Jun 7.
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.’
Differences in eye movements and reading problems in dyslexic and normal children.
Eden GF1, Stein JF, Wood HM, Wood FB.
Vision Res. 1994 May;34(10):1345-58.
Conclusion: ‘… A qualitative assessment of saccadic eye movements revealed that dyslexics exhibit fixation instability at the end of saccades… Sex, handedness, IQ or the presence of attention deficit disorder (ADD) did not appear to influence the children’s performances on any of the eye movement tasks. The presence of oculomotor abnormalities in a non-reading task strongly suggests that the underlying deficit in the control of eye movements seen in dyslexics is not caused by language problems alone.’
Association between reading speed, cycloplegic refractive error, and oculomotor function in reading disabled children versus controls.
Quaid P1, Simpson T.
2013 Jan;251(1):169-87. doi: 10.1007/s00417-012-2135-0. Epub 2012 Aug 29.
Conclusion:
‘This research indicates there are significant associations between reading speed, refractive error, and in particular vergence facility. It appears sensible that students being considered for reading specific IEP status should have a full eye examination (including cycloplegia), in addition to a comprehensive binocular vision evaluation.’
