When a Vision Related Learning Problem is not Convergence Insufficiency

Reading trouble.

It seems that when Vision Therapy is mentioned then the following condition seems to be automatically mentioned and that is Convergence Insufficiency (CI).  CI  is that binocular condition in which the two eyes have difficulty maintaining near demanded tasks. This condition may result in double vision, asthenopia, and headaches.  No wonder it would cause reading issues as well as learning related problems. But, you don’t have to have this visual condition to have a visually related learning problem.

General visual skills dysfunction can be comprised of inadequate teaming skills, inadequate eye movement skills, focusing (Accommodative) problems or visual processing skills.

Teaming skills can be inadequate. This means that the skills may not provide the desired ranges necessary  for free and easy binocular movement of the eyes. The eyes seem to fatigue easily, asthenopia or discomfort sets in, headaches may or may not occur, or the individual just has no desire to read for any length of time.

Eye movement skills may be inadequate.  Simple observation may reveal inadequate fixation or scanning skills.  Evaluation may include but is not limited  to Fixation tests such as the modified King-Devic test.  A timed test of displayed single digit numbers in an array called out by the patient.

Focusing problems may be exhibited by what the optometrist refers to as Accommodative Infacility.  AI is an inability to change focus rapidly from near to far and then far to near.  Usually the child is slow at copying information from the board. This exhibits a delay in focus slowing down the child as he waits to receive the distance information and then responds with the near activity which is in most cases writing the information down.

Visual Processing skills can be measured in a variety of ways;

1) Visual Memory

2) Visual Motor Integration Skills-Speed and Accuracy


4) Letter Reversals

Visual Memory can be tested in many ways but so much information is gathered when the memory test is presented as a set of symbols that must be memorized and reproduced on paper. Visual Motor Integration-SA is an evaluation that requires the gathering of information (eyes), the processing of the information (visual brain) and then the integration or the use of this processed information. Visualization is tested by manipulating shapes in the mind.  It is an important skill especially when incorporated with reading.  In order to retain the written word it must be visualized.  Letter Reversals is a controversial area, but has been related to higher orders of vision in respect to visual processing. Due to the complexity and controversy of the subject, Letter Reversals will be discussed in detail at a later date.

Teaming, focusing, and fixation skills along with visual processing skills may be at the core of most learning related problems.

Dr. Dan