4 thoughts on “Nice Inforgraphic on Importance of Annual Eye Exam Via Visionworks

  1. Best data I’m aware of is from here: http://www.advancedvt.com/Resources/OSU%20Study%20IEP%20Vision%20Problems.pdf
    The epidemiology section of that CPG cites sources that at least 20 percent of individuals with learning disabilities are thought to have a prominent visual information processing deficit, and that the prevalence of clinically significant visual efficiency problems is thought to be in the 15 to 20 percent range. Given that there is some overlap in the two populations, but that there are other visual conditions that aren’t defined as either VIP or Efficiency deficits, 40% is a number that seems reasonable.

    Goldstand, Koslow and Parush suggests something closer to the 60% figure:
    http://ajot.aota.org/article.aspx?articleid=1872088

    Joel Zaba offered some roundabout stats that support this being in the ballpark
    http://usa.essilorvisionfoundation.org/wp-content/uploads/2013/07/White-Paper.pdf

  2. From Zaba: “In school districts in disadvantaged areas, the statistics are even more alarming. Research with Title I students in the fifth through eighth grades, and academically and behaviorally at-risk children ages 8 to 18, up to 85% of these children had vision problems that were either undetected or untreated.” I have seen this in my own practice, and interestingly, while in isolated aboriginal communities you find very high rates of refractive errors, the visuomotor skills deficits do not seem to be as high as in larger more urban communities where RE is more variable, affecting fewer people proportionally, but where visuomotor deficits are more common.

    It’s important to note also that in the AJOT piece, the standard is the MCT, which is not designed as a comprehensive visual skills battery. In the population studied, 68% of the cohort had measurable (read ‘significant’) functional deficits, but this includes functional readers as well. One of the issues with any discussion like this is in defining the population and what is meant by ‘LD’ in the first place. No study can ensure a homogeneous neuro-typical population.

    Then it gets even more complicated: “When looking at the errors occurring in the antisaccade task (Fig. 2.11) one sees also a strong development with age in both groups. However, here the differences between the two groups are very clear for all age groups except the youngest. At age 7 or 8 years both groups reached mean error rates of just below 80%, i.e. neither group was able to perform the antisaccade task without glancing at the stimulus. As they become older both groups decreased their error rate significantly, but the differences between the groups became larger. The percentage of off-limit responses increased from 18% to almost 60%. Unlike the reaction times, the error rate did differentiate between the groups at all ages except the youngest. It seems that with the beginning of school both groups start the development of a new capacity, namely the ability of their frontal cortex to control their saccades.” – Stein, John; Kapoula, Zoï (2012-08-23). Visual Aspects of Dyslexia (Kindle Locations 878-884). Oxford University Press. Kindle Edition.

    I suspect that if we could identify just the children with primary reading disability and accounted for RE (i.e. reading only, no other physical/physiologic deficits), we would find on average a much higher rate of visual skills deficits and that could likely hit the 80% mark. Reading requires spatial understanding and the ability to execute anticipatory actions in memory, spatial calculus, and motor control – dyslexics do show much greater trouble in these areas, as noted by Stein and Kapoula and others.

    In the end, the answer to the question ‘what percentage of LD children have also significant visual impediments?’ might best be stated as “what do you mean by LD and what do you mean by visual deficits?’. This is a big and very nuanced topic, and no independent estimate should be taken as gospel, but it’s safe to say the number is high, as is the the general frequency of visual impediments to learning and development. One broad conclusion is that visuomotor skills in general are a great indicator of learning readiness and these can and should be used as early markers for rehabilitative intervention.

  3. In unpublished research from 1977-79, “The Oak School Project,” virtually all children in this special education population in Chicago had undetected/untreated vision disorders. When those problems were addressed, there were dramatic changes school wide. The school psychologist was using the Slingerland on all students with average progress of 10 months each year. When vision problems were addressed the children progressed 2 years on average over one academic year. There were no other interventions over this time. This paper is available in the 1980 transcripts of the Skeffington Invitational Symposium on Vision Therapy.

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