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Vision is Being Misdiagnosed as ADHD

A recent study by researchers at the Children's Eye Center", default", University of San Diego, uncovered a relationship between a common vision disorder, convergence insufficiency, and ADHD.

The study "showed that children with convergence insufficiency are three times more likely to be diagnosed with ADHD than children without the disorder."

Pediatric Optometrist or Pediatric Ophthalmologist?

A parent recently asked why I recommend that her child be examined by a pediatric optometrist rather than a pediatric ophthalmologist. The answer comes from my understanding of these two types of eye doctors and my personal experience.

Both types of eye doctors examine and prescribe glasses, diagnose and treat eye disease, and can evaluate how well a person uses the eyes together. However, each profession is unique.

Ophthalmologists are trained to do surgery. I credit one with saving the eyesight of my daughter, who at age five sustained an eye injury. Optometrists are schooled in the developmental (behavioral, functional or environmental) aspects of vision. Optometrists are more apt to use lenses, prisms and vision therapy to enhance and improve visual function. These interventions often improve children's academic and other abilities.

Eye Exams

A child's comprehensive eye examination should include the testing of the following visual skills which are aspects of normal, healthy vision.

Acuity-Distance: visual acuity (sharpness, clearness) at 20 feet distance.

Acuity-Near: visual acuity for short distance (specifically, reading distance).

Focusing Skills: the ability of the eyes to maintain clear vision at varying distances.

Eye Tracking and Fixation Skills: the ability of the eyes to look at and accurately follow an object; this includes the ability to move the eyes across a sheet of paper while reading, etc.

Binocular fusion: the ability to use both eyes together at the same time.

Stereopis: binocular depth perception.

Convergence and Eye Teaming Skills: the ability of the eyes to aim, move and work as a coordinated team.

Hyperopia: a refractive condition that makes it difficult to focus, especially at near viewing distances.

Color Vision: the ability to differentiate colors.

Reversal Frequency: confusing letters or words (b, d; p, q: saw, was; etc.)

Visual Memory: the ability to store and retrieve visual information.

Visual Form Discrimination: the ability to determine if two shapes, colors, sizes, positions, or distances are the same or different.

Visual Motor Integration: the ability to combine visual input with other sensory input (hand and body movements, balance, hearing, etc.); the ability to transform images from a vertical to a horizontal plane (such as from the blackboard to the desk surface).

Some basic eye exams or vision screenings test only one of the above: Acuity-Distance (clarity of sight in the distance, 20/20 eyesight).

An eye exam that tests distance vision only is NOT an adequate evaluation of a child's visual development. The visual skills listed above contribute significantly to a child's success with reading and school achievement.

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