As another school year is brought to a close, we need to ask again why so many children struggle in their classes. Sometimes the answer is right in the front of our face.
When I was in second grade, I did miserably on a standardized achievement test. The school principal told my parents that I was, "a dim bulb," and I was placed in a class with other "problem" children. But the principal was unaware of the connection between vision and reading. I was cross-eyed and, in the previous five years, my eyes had been surgically rearranged in their sockets three times. I had 20/20 eyesight with each eye, but even after the operations, my two eyes still did not point to the same place at the same time. In fact, when trying to read, I saw letters with my right eye that were to the left of those I saw with my left eye. No wonder I had trouble pinpointing the letters on the page and did not like to read.
Poor eye coordination affects more than the four percent of children who are cross-eyed or walleyed. An additional five percent of children (about one per classroom) have a condition called "convergence insufficiency." Although their eyes look straight and they may coordinate them well for far viewing, they do not use them well when they look near. When they try to read, the letters appear blurry or doubled. Since a young child may not know that this is abnormal, he may not report what he sees to his teachers or parents. Sadly, this condition is not picked up by the standard school eye exam which tests only how well one eye sees at a distance of twenty feet. As a result, the child may be diagnosed with a learning disability, or if he misbehaves in frustration, with ADHD.
Even if a child's vision disorder is diagnosed, it can be surprisingly difficult to obtain the proper treatment. According to a recent National Eye Institute study, the best treatment for convergence insufficiency is optometric vision therapy. Yet, ophthalmologists and pediatricians are not generally trained in vision therapy and don't always refer the patients to the developmental/behavioral optometrists who are. Medical insurance companies may not cover the treatments making the vision therapy difficult to afford.
If we really want to help our children to learn, then we need to provide them with a thorough binocular vision exam before or at the time they enter kindergarten. Such testing could provide huge savings as children struggling with reading in school may then get the early intervention they need. Detecting vision problems early and seeking the right treatment can change a child's vision and transform a child's life.
Note: I wrote about this issue in a recent Op-Ed published in the Los Angeles Times and in my book, Fixing My Gaze. Another good website to learn about the connection between vision and reading is here.