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Learning Related Vision Difficulties

Does your child lose their place, and miss out letters, words or lines when reading?  Do they re-read lines, or miss out lines completely, and find that they cannot remember the text? These are some of the symptoms of learning related vision difficulties.

Sight is our dominant sense, and our primary source for gathering information in learning. But that is only part of the story as sight links with the other sensory information, and previous information, to create vision, which takes place in over 36 places in the brain.  Two thirds of our brain’s pathways are involved in vision.

Vision problems can have a profound effect on how we learn, and may present with a wide range of signs and symptoms.  Some symptoms, like eyestrain or blurred vision, can usually be attributed directly to a vision difficulty.  Others, such as poor attention span at school, clumsiness in sports, or reduced productivity at work, may not immediately be recognised as possible signs of a vision problem.

A learning related vision problem directly affects how we learn, read, or sustain close work. Vision problems in any of the following areas can have a significant impact on learning:

  • eye tracking skill - eyes following along a line of print; and eyes jumping from one word to the next, and from one line to the next.

  • eye teaming skill - two eyes working together as a synchronized team to fuse the two images, and see them binocularly as a single image, with depth perception.

  • accommodation - eye focusing ie changing the power of the lens of the eye to enable focusing from a distant object to a near object and back again.

  • visual-motor integration - eye-hand coordination.

  • visual perception - visual memory, visual form perception, and visualisation.

Are these skills automatic so that they can be used easily and comfortably, as well as accurately and without effort? Is there flexibility in the visual system so that a person has the skill to meet each and all situations?

As vision and learning are intimately connected, a vision problem can be easily mistaken for a learning problem. Children with undiagnosed visual problems can be diagnosed as having Learning Disabilities, ADHD, Dyspraxia or Dyslexia.

Unfortunately, parents and teachers often incorrectly assume that if a child can read the small letters on a sight testing chart then there is no vision problem.  In reality, the vision skills needed for successful reading and learning are much more complex.  A child that can see the bottom line on the chart can still have a vision problem.

Behavioral Optometry

Behavioural Optometry is an expanded area of optometric practice.  A Behavioural Optometrist believes that your visual status, and the way that you interpret what you see, does not depend solely on how clearly you can see a letter chart. Consideration must be given to all your visual, visual motor and visual perceptual skills. The aim is to develop and enhance the visual skill needed to achieve more effective visual performance at work and play (classroom, sports, work place), and to prevent vision problems and eye problems from developing.

To achieve these goals a Behavioural Optometrist may recommend the use of carefully prescribed lenses, prisms and/ or tints, and will give advice on visual hygiene techniques to prevent or reduce the possibility of eye problems developing.  A Behavioural Optometrist may also prescribe a programme of Optometric Vision Therapy to enhance and develop visual skill that is poorly or inadequately developed. Learn more about Vision Therapy here.

Learning related vision difficulties not only affect children learning to read. It may be that a child has adapted their visual system and managed to learn to read, but struggles as they reach senior school when the work becomes harder. Children do not ‘grow out’ of learning related vision difficulties, and many adults find that they have problems when working, particularly with office and computer work. Behavioural Optometrists can help children, adults, athletes, patients with autistic spectrum disorders and patients with traumatic brain injuries.

In the UK Behavioural Optometrists are trained by the British Association of Behavioural Optometrists (BABO) with links to Behavioural Optometry Associations and courses across the world. BABO maintains a Register of Accredited Members that are prepared to accept referrals, and who are verified as having met the requirements for annual continuing education in Behavioural Optometry.  Caroline has been an accredited member of BABO since 2002, and was Chairman of BABO from October 2004 to October 2011. She lectures on Behavioural Optometry in the UK and Europe, Scandinavia, USA, Canada, Australia and New Zealand.

To find out more information about BABO please check their website on

Finally, here is a list of common signs or symptoms of learning relater vision difficulties that may indicate the need for an examination with a Behavioural Optometrist.

Performance Problems

  • Poor reading comprehension

  • Difficulty copying from one place to another

  • Loss of place, repetition, and/or omission of words while reading

  • Difficulty changing focus from distance to near and back

  • Poor posture when reading or writing

  • Poor handwriting

  • Can respond orally but can't get the same information down on paper

  • Letter and word reversals

  • Difficulty judging sizes and shapes

  • Poor gross and fine motor skill

  • Clumsiness, and poor judgement of the space around them

  • Very tired at the end of the school/work day

Physical Signs or Symptoms

  • Frequent headaches or eye strain

  • Blurring of distance or near vision, particularly after reading or other close work

  • Avoidance of close work or other visually demanding tasks

  • Poor judgment of depth

  • Turning of an eye in or out, up or down

  • Tendency to cover or close one eye, or favour the vision in one eye

  • Double vision

  • Poor hand-eye coordination

  • Difficulty following a moving target

  • Dizziness or motion sickness

  • Making head movements rather than eye movements when reading

Binocular Vision Assessment

A full binocular vision assessment takes around an hour and a half, and includes the usual eye examination together with testing of the visual performance to see how well the eyes are able to cope with the requirements of a work or school day.

Here is a  Link to  Vision, Learning and Dyslexia – A Joint Organizational Policy Statement.

And here is a link to a TED talk on Vision and Learning given by Keith Holland from BABO:

If you think that you, or a member of your family, has vision-related learning difficulties then please call in at the practice, or book an appointment by clicking below.

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