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Helping the child that struggles academically at school from the perspective of a developmental Optometrist.

There are countless reasons why children struggle with school work.

We will be focusing on the VISUAL system and the role it plays in learning, reading and academic achievement.

There are at least two very important categories to deal with;

  1. Dyslexia
  2. ADHD/ADD and its subsets.

These are not necessary mutually exclusive and both conditions may play a role in the child’s struggle and frustration with conventional learning.


The most frustrating two issues when dealing with children’s vision problems I have encountered is that parents almost universally report that the child


And that is why we have tried everything else and now we are desperate and want to check the vision.

  1. We have checked the eyes and the child has 100% vision so it CANNOT BE A VISION problem?

You may very well agree with the above and it might well be something that you have already experienced with your child as well and that would be quite a normal response.

This may however be the correct reason your child is so underperforming when you know he is intelligent, healthy and coping well in other spheres of his life.


Children see what they see. They have no ability to decide that seeing blurry or that letters that move or jump on the page is abnormal. So why would they complain?

They only have symptoms and behavioral abnormalities relating to the visual problem experienced

A conventional (standard) vision exam may either miss or not test for the following important visual abilities.

  1. Near point of convergence problems. The #1 vision cause of incorrectly diagnosing ADHD.
  2. Inability to sustain accommodation.
  3. Pursuits and saccade abnormalities.
  4. Eye/hand co-ordination issues.
  5. Meares Irlen syndrome.

Please note that there are many more visual system/brain/body integration issues that I will not deal with in this article that have a major impact on school learning abilities.

Having read the above you may now be more confused than before. The important of this is that you now understand that there are various levels of visual examination and that vision problems CAN go undiagnosed with a conventional eye exam. So now that I am aware of the various issues that can impact my child’s visual system and render the whole learning process inefficient, frustrating and debilitating.

What can I as a parent do?

The first practical question to ask is the following;

Is the reported inability to concentrate on school work (near sustained visual tasks) repeated at home when doing (distance visual sustained tasks) such as watching a TV program or a movie?

If the answer is NO then he CAN concentrate when doing distance visual tasks and remember very accurately when questioned about the content. He may very well have a near vision problem and require a comprehensive visual system examination which includes checking for the five visual problems which cause many of the same symptoms of ADHD and Dyslexia. Only once these issues have been RULED OUT further non visual interventions may be appropriate in your child’s continuing struggle to learn. Once again this is a simplified explanation of a very complex system that interrelates with vision (80% of the brain is involved with vision) intelligence, developmental issues, nutrition and environment.

The second question to ask is the following;

Does my child’s ability to read and concentrate on near sustained visual tasks degrade over time?


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