These are some resources that I found useful or interesting when researching my son’s condition (convergence insufficiency).
If you have not read my blog post about our family's own dealings with an eye tracking problem for one of my sons you can read it here. There are some different links in there and most importantly a LONG SYMPTOM LIST.
This is not a comprehensive list of everything there is to know about all the various eye tracking issues. These are resources that I felt helped me in my research. I am sure there is a lot more information out there, and I am sure there are more articles about other eye tracking issues that are different than the one my son has.
Behavioral Optometrists are trained to do eye tracking testing in order to diagnose eye tracking disorders. Pediatricians are not trained to do that kind of evaluation. Eye tracking problems are not detected by reading the eye chart on the wall. A ‘visual acuity’ test done by a health care professional (even by an opthalmologist) is not the diagnostic tool that can make this diagnosis. There is special testing to check for eye tracking problems and issues with the field of vision. If your child has never seen a Behavioral Optometrist for ‘eye tracking testing’ then they have never been tested to see if the have an eye tracking disorder. As you will learn from reading some of the articles listed below, even a visual acuity test result of 20/20 vision does not mean that the person does not have an eye tracking problem.
Note that sometimes a reading specialist at school or a school teacher is the first person to suggest that your child may have an eye tracking disorder, if the child is struggling to learn to read or if they are already reading but now are having reading comprehension struggles. There are certain symptoms that can indicate a problem with eye tracking that are easily detected by people, such as a child turning their head sideways to read, squinting or trying to read with one eye. For more symptoms please read a symptom list.
1. Question: What are eye tracking problems? What is convergence insufficiency?
For the answer this article will be helpful:
Article: “Vision & Reading: The following are excerpts from an article on Vision, Learning and Nutrition” by Donald J. Getz, OD, FCOVD, FAAO
This site is a good starting place, see the other articles on the site. For example it has a listing of different vision and eye tracking conditions with summaries of each and some symptoms listed. It briefly mentions a link with the child’s nutritional intake at the end to poor nutritional intake possibly being correlated to problems with learning.
2. Article: What is Convergence Insufficiency (CI)?
See also the links off of this page on the same site for more information.
3. College of Optometrists in Vision Development (COVD) website is a good resource. Here is one quote:
"Mission: Our mission is to serve as an advocate for comprehensive vision care emphasizing a developmental and behavioral approach. COVD certifies professional competency in vision therapy, serves as an informational and educational resource, and advances research and clinical care in vision development and therapy."
This home page of website of COVD links provides articles, press releases, and an “in the news’ section.
Articles of note on the COVD site:
Article: The 20/20 Myth
Article: Signs and Symptoms
Article: Insurance Coverage for Vision Therapy
Locate a Doctor Near You (see sidebar on home page)
4. Convergence Insufficiency page on EyeMDLink.com site
5. Wikipedia entry on Convergence Insufficiency. Note the links section for the Wikipedia entry, you may find even more useful information there that is not included in my blog entry.
6. Question: Can a child with a 20/20 vision test result have some other eye problem that affects their learning?
For one answer, see this article: Success in School: 20/20 Eyesight is Not Enough!
Article: Success with Visual Disabilities: Convergence Insufficiency
7. Regarding the diagnosis of strabismus---
Question: Is surgery necessary to treat strabismus?
An ophthalmologist may recommend eye muscle surgery (possibly as the first or only recommended treatment). A non-surgical option is vision therapy with a Behavioral Optometrist. Read more info here about what these doctors have to say about eye muscle surgery and strabismus:
All About Strabismus page with many links
All About Surgery page with many links
8. Treatment of Eye Tracking Problems
Option A: Eye Exercises can be done in the doctor’s office and sometimes at home. These exercises also go by these names:
Wikipedia entry for orthoptics
For more information do a google search by the keywords 'orthoptic therapy' and/or 'orthoptics'.
Orthoptist/Orthoptics page on the American Association for Pediatric Ophthalmology and Strabismus’ website
When asking your medical or vision insurance if they cover it be sure to use the different medical terms to help you find the answer.
Option B. Light therapy treatment is another type of therapy that can be done instead of or combined with orthoptics.
Light therapy also goes by these other names:
Article: What is Syntonics? At College of Syntonic Optometry’s site
About: Syntonics (Optometric Phototherapy) at Dr. Rummel’s site (he is a New Jersey Behavioral Optometrist)
About: Optometric Phototherapy (Syntonics) at Australasian College of Behavioural Optometrists’ site (Australian spelling, not an error)
9. Dual or Misdiagnosis---Find out about co-diagnosis or possible mis-diagnosis with ADD/ADHD because it is said that eye tracking related learning problems may cause misdiagnosis of ADD/ADHD or children with ADD/ADHD might also have eye tracking problems.
Here is a quote from that article:
"Regarding the article and study on this page, Dr. Granet of the Children's Eye Center commented, “We don't know if convergence insufficiency makes ADHD worse or if convergence insufficiency is misdiagnosed as ADHD. What we do know is that more research must be done on this subject and that patients diagnosed with ADHD should also be evaluated for convergence insufficiency and treated accordingly.”
Another site with an ADD relevance has this article:
Scientific Studies on Connection Between Vision Disorder (Convergence Insufficiency) and ADHD
10. Can there be a dual diagnosis of Autism and Asperger’s Syndrome?
On various sites it has been mentioned that double vision caused by convergence insufficiency may be the cause of some eye contact symptoms or delayed reading seen in children who have been diagnosed with Asperger’s Syndrome or Autism. Since children on the autism spectrum sometimes struggle with learning and were never tested for eye tracking problems, some suggest checking for the presence of an eye tracking problem and seeking vision therapy if an eye tracking diagnosis is made.
This New York Times article mentions a child with this situation.
In a related article in The New York Times from 2002, a Yale study suggests that doing eye tracking testing in children younger than three, may help them make an earlier diagnosis of Autism.
Article: Experiment Offers Look Through Eyes of Autism by John O’Neil
11. Dianne Craft’s advice:
Dianne Craft is a special education teacher with over 25 years of experience, and is a nutritionist. She homeschooled her child, and is a homeschool conference speaker. She believes there is a link between nutrition, the body and the brain’s ability to learn. She feels there is a nutritional component to learning disabilities, learning struggles, children with allergies and children on the Autism spectrum—all who can benefit from changes in diet. She is on staff with HSLDA to help parents of children with special needs. HSLDA members can call and speak to one of their staff special needs educators for advice about continuing to homeschool a child who has a learning disability.
You can read more of her articles on her website Dianne Craft.org and learn about her brain integration therapy which parents can do with their children at home. She was a speaker at the 2008 MassHope Christian Homeschooling Convention and mentioned in one of her lectures that eye tracking conditions and dyslexia are sometimes seen in children with ADD/ADHD or perhaps they are not diagnosed with the learning problems and mis-diagnosed with ADD/ADHD.
Dianne Craft’s website, home page
Article: Visual Processing Dysfunction Characteristics by Dianne Craft posted on HSLDA’s Struggling Learner page. Follow links at bottom for more information.
11. Newspaper Articles about Eye Tracking Problems
Article: “Vision Therapy Helps Children with "Hidden Disability" published in the Boston Globe in 2002. Mentions that sometimes a misdiagnosis of “non-verbal learning disorder”, dyslexia or ADD/ADHD is made when really the child has an eye tracking problem.
Quote from the Boston Globe article:
"The letters swim on the page, giving the children headaches. Children try to compensate by bobbing their heads back and forth to constantly refocus their eyes, or shutting one eye and reading with the other. They invariably fall behind and become frustrated with reading, Orfield said. Most do not report a problem reading because they do not realize that their experience is abnormal, she said. And administrators often mislabel these children as suffering from a learning disorder, such at attention deficit hyperactivity disorder or dyslexia, when in fact it is their vision that is impaired.
"It's a hidden disability," Harris said. "There's a strong implication that we may be over-medicating our kids." Vision therapy, he said, can make a huge difference.
"Kids who go through my program make a 73 percent jump in reading, on average," Harris said. "This is a school problem that should be treated in school. It's much less expensive to do it in school than in private practice."
"The good news, Harris said, is that the human eye can be retrained to visualize properly. The only hurdle is access to the proper medical professionals and treatments."
New York Times article: ”Not Autistic or Hyperactive. Just Seeing Double at Times” by Laura Novak, published 9/11/2007
Quote from the New York Times article:
“Dr. David Granet, a professor of ophthalmology and pediatrics at the University of California, San Diego, said: “Everyone is familiar with A.D.H.D. and A.D.D., but not with eye problems, especially not with convergence insufficiency. But we don’t want to send kids for remedial reading and education efforts if they have an eye problem. This should be part of the protocol for eye doctors.”
In 2005, Dr. Granet studied 266 patients with convergence insufficiency. Nearly 10 percent also had diagnoses of attention deficit or hyperactivity — three times that of the general population. The reverse also proved true: examining the hospital records of 1,700 children with A.D.H.D., Dr. Granet and colleagues found that 16 percent also had convergence insufficiency, three times the normal rate."
One last note from me:
A Note About Other Medical, Psychological Conditions and Learning Disorders
The above linked articles and websites have stated that sometimes children with eye tracking problems also may have an ADD or ADHD diagnosis, or be diagnosed as being on the Autism Spectrum. In some of the above articles it was also mentioned that sometimes the child also has a diagnosis of (or was treated for or was misdiagnosed as having) anxiety disorders, depression, and/or neurofibromatosis.
Children with an eye tracking problem may also have dyslexia, dysgraphia or a learning disability diagnosis of a ‘non-verbal learning disorder”. If your children already has one or more of those other conditions if there are still having learning struggles and they have the symptoms of an eye tracking problem, you may want to consider a consult with a Behavioral Optometrist to see if an eye tracking disorder is present as well.
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