Dr Joel Warshowsky says there are many highly intelligent children around the world that struggle in the classroom when it comes to learning, behaviour and attention due to visual disorders. These visual disorders are often misdiagnosed and/or overlooked by eye doctors as something insignificant because most eye doctors believe if a child has 20/20 vision there is no need to look any further for any visual condition, he said.
Children with visual dysfunctions often have a hard time differentiating between what is real and what is illusion, he said.
Dr Warshowsky is a behavioural and development optometrist in the United States. A world leader in the field of Optometric Visual Therapy, his 35 years of experience has changed the lives of children and their families all over the world. Though it might not be as apparent to the "average Joe" what behavioural disorders have to do with eyesight, Dr Warshowsky examines the potential link between the two from the cause to treatment.
He said, "The two principle functions of vision direct action and derives meaning. Children with visual dysfunction, not necessarily eyes/eyesight issues, are unable in knowing where their body or their position is in space as well as not being inaccurate in maintaining and sustaining attention to visual detail. This instability and inaccuracy creates frustration and anxiety which can potentially lead to a lack of self awareness which becomes defined as an inhibited sense of self resulting in self described behavioural disorders. Think of a Fun House in an amusement park where mirrors distort visual reality. You get to a point where you just want to get out. Children with visual dysfunction can't get out."
"Visual dysfunction creates the frustrations and anxieties that beg the development of behavioural disorders. The lack of ability to attend to visual detail creates the platform upon which a lack of comprehension leads a child to become learning disabled," he said.
Dr Warshowsky said what causes it is still unknown however genetics and/or development are considered as the main cause for this condition.
"Regular eye exams don't typically consider eye coordination, focus and tracking skills related to how one develops their visual perception. A typical eye examination evaluates clarity, 20/20 vision. Evaluation in the areas of vision that concern itself with eye coordination, focus and tracking skills enable an assessment of these functions needed to adequately assess functional vision and the associated behaviours that result," he said.
"A child with learning disabilities has difficulty being able to decipher the written word, comprehension. Visual inaccuracy associated with loss of place, skipping of lines, omissions and substitutions may be associated. The typical signs will often reflect aspects of the diagnosis of convergence insufficiency and associated focusing and tracking disability," he said.
"Upwards of 80 per cent of learning is derived by what one would consider good vision as believed by most affiliated academics. Vision will typically dictate how children will succeed in their learning. If vision is primarily functional, learning will typically meet potential with all else being equal. If not, school-aged children will be compromised. They will see and function in a distorted visual world. It is primary and principle for children to have their vision free of dysfunction if they are to succeed to potential," he said.
"Behavioural disorders and or learning disabilities tend to affect more boys than girls. It is not known why, but it is relatively well established that girls develop overall more quickly than boys," he said.
When it comes to signs/ symptoms of a child with learning disabilities, according to Dr Warshowsky, the child has difficulty being able to decipher the written word, comprehension. Visual inaccuracy associated with loss of place, skipping of lines, omissions and substitutions may be associated. The typical signs will often reflect aspects of the diagnosis of convergence insufficiency and associated focusing and tracking disability, he said.
Dr Warshowsky said the treatment of choice for visual dysfunction and associated behavioural conditions are behavioural lens prescription and vision therapy however it still remains a controversial topic for many doctors within the vision care field. There are some doctors like Dr Warshowsky who are strong advocates for vision therapy and other doctors who are still not convinced on its effectiveness and do not recommend it.
The website www.allaboutvision.com states that vision therapy is a doctor-supervised, non-surgical and customized programme of visual activities designed to correct certain vision problems and/or improve visual skills. Vision therapy is like physical therapy for the visual system, including the eyes and parts of the brain that control vision.
It goes on further to state that the overall goal of vision therapy is to treat vision problems that cannot be treated successfully with eyeglasses, contact lenses and/or surgery alone, and help people achieve clear, comfortable binocular vision.
Dr Warshowsky said, "Unresolved visual dysfunction and subsequent visual symptoms typically create unease, instability and uncertainty in how children view their visual reality, their visual world. What do I see as real and what do I see as an illusion? Children with visual disability are forever trying to recognise the difference. The affect that symptoms of visual dysfunction have upon children is a general feeling of uncertainty."
He noted the longer visual dysfunction goes untreated the longer it prevails, the harder it is to resolve; and the more a child sinks into believing that they are a failure.
A vision loss fact sheet taken from the Centres for Disease Control and Prevention (CDC) website states:
Your child should be checked for vision problems by an ophthalmologist, optometrist, paediatrician, or other trained specialist at:
–newborn to 3 months
–6 months to 1 year
–about 3 years
–about 5 years
They went on further to state that having your child's vision checked is especially important if someone in your family has had vision problems.