
Visual issues and dyslexia
Answers to the most frequesntly asked questions about dyslexia and visual issues
What are the roles of professionals in eye care?
Optometrist:
- usually based ‘on the high street’
- undertakes the NHS Primary Eye Examination and prescription for corrective treatment
- is trained to detect certain general health conditions which show themselves in eye examinations
- may refer on to other professionals.
Optician (or dispensing optician):
- provides glasses (and sometimes contact lenses) based on a prescription supplied by an optometrist or ophthalmologist.
Ophthalmologist:
- diagnoses and treats disorders both medically and surgically. Generally speaking, ophthalmologists will be employed in hospital eye departments.
Orthoptist:
- Usually based within the NHS specialists in visual development and binocular vision. They work as part of multidisciplinary teams alongside optometrists, ophthalmologists and other health care professionals such as paediatricians
- diagnoses and provides therapy for eye muscle problems which can impair how the eyes work together causing difficulties with seeing single and doing close work
- specialises in how the brain uses vision during reading etc and specialize in pediatrics and neurological visual issues after strokes, neurological disorders, glaucoma and brain injury.
Behavioural Optometrist:
• concerned both with eye care and with how vision is processed into meaning uses both lens treatment and vision therapy (exercises) to treat visual and visual perceptual difficulties.
What are motor and visual perceptual difficulties?
Motor visual difficulties occur when the eyes are not being controlled well together (Binocular Vision) or when the focusing and coordination of the eyes is not working well making reading difficult. Visual perceptual difficulties are not about the eye being able to ‘see’ an image but how the brain processes the information that the eye has captured. They are not the cause of dyslexia but they can make reading, writing spelling and coordination more difficult and are found in many people.
Is this the same as being dyslexic?
No. Some of the difficulties caused by motor and visual perceptual difficulties may be mistaken for dyslexia because they interfere with reading . Dyslexia is primarily a language processing difficulty where learning the sounds in language and relating them to the visual appearance of letters is very difficult. However, motor and visual perceptual difficulties are present in a wide range of conditions and have varying impact on learning.
Some visual problems like binocular vision problems are more widely reported in those who struggle with reading and this may be contributing to the reading difficulties when someone is dyslexic but can be very easily corrected.
Not all dyslexic people have visual perceptual difficulties but they make may visual errors during reading. You can have any of these conditions and not be dyslexic. It is possible to have more than one visual difficulty. It is also possible to be unaware that you have a visual difficulty.
What should I do if I suspect someone is having this type of difficulty?
Ask – what does it feel like when you read?
Pay particular attention to the way they describe how it feels physically. For example they might say it makes their eyes feel scratchy or makes their head hurt.
Ask – what does it look like when you read?
For example, they might say they have to ‘catch the words with their eyes’ to stop the words moving, or that it looks like the text is dissolving.
Ask – what seems to make it easier or more difficult?
Use different examples of text in different font types, sizes and background colours and talk about them.
Observe – do you notice any of these things?
- They seem to get watery eyes
- They rub their eyes
- They move their head or the page around
- They follow the text with their finger
- They seem to squint
- They need to move the page further away or have their head close to the page
- They need additional lighting or need the lights low.
Observe – when reading out loud do they do any of these things?
- Skip or omit words
- Miss the beginning or end of words or punctuation marks
- Run words together and miss the gaps between
- Use a finger to follow the text
- Seem to find it more difficult or make more mistakes the longer they read for
- Mix up lines of text or columns of numbers, such as in a table.
What should I do next?
When you have gathered information about all of the symptoms, go to your Optometrist.
It is important that all of the information is passed onto the person carrying out any eye test. Make sure that you describe all the symptoms and difficulties that have been observed.
Specialist tests are needed to detect all the possible motor and perceptual difficulties and not all practices do this.
Many of the difficulties might not show up in a standard eye test. For example you might be able to read the line of text shown to you but you might not be able to sustain this over a full page of text without difficulties.
The person you go to must be a fully qualified Optometrist/Orthoptist. They must be able to assess for a number of different difficulties, many of which will give similar symptoms. If they are not a specialist in reading difficulties they will be able to suggest someone in your area who has done additional training in dyslexia and reading difficulties.
Following the eye test, an Optometrist might carry out additional tests, prescribe lenses and if necessary refer you for further tests or treatment with an Orthoptist or other professional.