Pediatric Vision Disorders
Vision and Reading (2)

Astigmatism, Eye-Hand Coordination, Visual-Motor Problems and more:
Children with coordination type visual problems can often be spotted in a classroom. They get into distorted postures in an attempt to get one eye out of the act. They often put their head down on their arm, cover one eye with their palm or rotate their head so that the bridge of their nose interferes with the vision from one eye.

Esophoria:
Another eye coordination problem is termed esophoria, which is a tendency for the eyes to turn inwards. The educational implication of this particular problem is that a child with esophoria sees things smaller than what they actually are. In order to see an object properly, it is necessary to make the object larger. The only means at the disposal of the child to make it larger is to bring it closer. Eventually, the child is observed with his head buried in a book and still not achieving.

Reading Skills and Binocular Visual Skills
One of the tests used in optometric offices is to have the child read words while looking into an instrument called a Telebinocular. The performance is compared between reading with either eye alone and with both eyes together. The difference in performance is often quite dramatic if there is an eye teaming problem. One eye performance might be quite satisfactory, but reading with both eyes together will be slower and many more errors will be made.

Directionality
Directionality is another visual skill important for academic success. One test for this skill is illustrated in the figure to the right.. Look at the figure and determine what you see. If the visual reflex is from left to right, a duck will be seen. However, if the visual reflex is from right to left, a rabbit will be seen. This is just one test out of a series to determine the directionality of the visual reflex.

It is a convention of our culture that the English language proceeds in a left to right direction. Other languages proceed in a right to left direction and still others have a vertical orientation. Many people feel that it would make more sense if the language proceeded as illustrated in the figure below. If a child does not visually proceed from left to right, through vision therapy he can be taught to develop this skill just like he can be taught to team his eyes together.

Form Perception:
Form perception is another important visual skill for academic achievement. This can best be illustrated by referring to Figure #7. The child is shown these forms one at a time and he is simply asked to copy them. It is amazing to see some of the distortions that a child will make in attempting to copy these forms. If a child can�t perceive and copy these simple geometric forms, it is unreasonable to assume that he will be able to perceive the wiggly lines which make up letters which in turn make up words, which in turn make up sentences which stand for abstract ideas. We see children often who can�t tell the difference between a square and a rectangle or a circle and an oval. This is also a skill which can be improved through vision therapy.

 

Attention Span/Span of Perception:
The Span of Perception is also related to success in school. Many children see just one word at a time with each eye fixation. Reading speed can be improved by learning to see two, three, or more words with each eye fixation. This could be compared to reading through a straw. This is illustrated in Figure #8 below. It is easy to see the difference in reading for meaning when the span of perception is wide.

Visualization:
The ultimate visual skill is visualization. This is similar to being able to see things in the mind�s eye. There are authorities that state that the ability to visualize is very closely allied to the ability to think. In other words, thinking is related to the ability to abstract from specifics and the ability to visualize is deeply involved in this process. Visualization is also a trainable skill.