Vision…academic problems and the emotional fallout

When a child struggles in school it is not only an academic problem. That’s just the tip of the iceberg. When a child struggles to keep up with their peers, it affects them emotionally, socially and physically. What is particularly troubling is how children with vision related learning problems often have emotional fallout that affects their self-esteem and can cause a spiralling of problems to cascade. Anxiety, worry and fear often can be rooted emotions within the child who has to deal with the side effects of a binocular vision problem.  Social difficulty can emerge making it difficult to make friends. This can lead to more withdrawn behavior, sedentary activities (video games, TV and computers)  and a general disinterest in three-dimensional play which in turn leads to a lack of physical development.

A greater number of media reports have been helping to provide vision education for the public. In this Fox News story you will learn about  a child, Isaac, who had a common binocular vision problem, Convergence Insufficiency. What is particularly interesting is to hear Isaac tell the reporter what it was like to have a vision problem that caused him to struggle in his reading. You might even think, “Hey, this kid seems pretty confident. After all, he actually stands up before a reporter and does a good job of answering questions.”  But, the viewer should also bear in mind that Isaac was properly diagnosed and treated. He had  office-based optometric vision therapy. He can muse about what it used to be like now that  his reading, sports and  performance overall is comparable or better than his peers. He is now confident!  

What is particularly troubling is, Isaac had to struggle needlessly. His parents thought his vision was ok because he passed all of the vision screening tests. Whether it be by the pediatrician or the school, routine vision screenings only determined that  his eye sight was fine. Therefore, sight-based vision screenings routinely miss patients who have binocular vision problems. Yet, binocular vision problems, like convergence insufficiency occur in nearly 1 in 12 children. In this story, if not for the persistence of his mother who found a doctor who could properly identify this condition, Isaac would have likely continued in a downward spiral of vision difficultly causing reading difficulty causing stress and emotional fallout.

Dr. Andrea Thau of the American Optometric Association helps to explain how this condition can affect a child in more ways than just the mere symptoms of a vision problem.

Let’s now look at another child,  in this case our patient  Zach whose parents gave us permission to share his exam video.  Zach, who completed his treatment for convergence insufficiency (office-based optometric vision therapy) returned to the office after 3 months for his progress evaluation.  He followed the protocol of NO home reenforcement for over 12 weeks to verify that he had maintained his abilities. Prior to treatment, Zach’s binocular vision problem caused headaches, eye fatigue, overlapping (double) words and reading was a lot of work. While Zach did not have a reading disability, he just found reading to be very stressful. It was described that Zach would have emotional “meltdowns” when required to read for any length of time. Look and listen to this chairside assessment of his oculomotor function you will see and hear a  child with a whole new emotional disposition.

Zach’s 3 mos post VT progress Eval

Zach’s 3 mos post VT progress Eval

The question for the reader is,  if so many children are affected with this condition,  why is there not a more coherent public health effort promoting vision education and advocacy for children with binocular vision problems, like convergence insufficiency?

Dan L. Fortenbacher, O.D., FCOVD