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to treat a binocular vision anomaly is that these anomalies are rarely
completely stable. One approach is to only diagnose an anomaly when
it has been detected on two separate occasions.74 Also, the ocular
motor status may worsen when the child is tired, towards the end of a
day at school. An indication of the effect of fatigue can be obtained by
repeating key clinical tests at the end of the eye examination.
Summary
The conditions discussed in this chapter and their relationship with
reading difficulty are summarised in Table 3.3. Some of these problems
(e.g., convergence insufficiency, accommodative insufficiency) are
more likely to be problematic when reading from smartphones
because they tend to be held closer than traditional reading
materials.75
People with reading difficulties have a higher than usual prevalence
of certain clinical visual problems, most notably visual stress, binocular
instability, and possibly convergence insufficiency and accommodative
insufficiency. The last three of these conditions have been discussed in
this chapter and the first is discussed in Chapters 6-9. All these visual
problems cause symptoms that could contribute to reading difficulties.
People with reading problems should therefore be referred to eye care
practitioners who have specialised in vision and learning and who can
carry out a specialised investigation to detect these problems, and any
other visual factors that may be relevant. These other visual factors are
discussed in the rest of this book and include conventional visual
problems (e.g., refractive error) and visual stress.
Another factor that needs to be considered when deciding whether
Vision, Reading Difficulties and Visual Stress
68
Condition
Relationship with
RD
Diagnosis
Management
Strabismus &
amblyopia
Not associated
with RD, but could
make reading
harder in rare
cases when
unstable
Optometric/orth
optic
investigation of
motor & sensory
status6
Eye exercises
or occlusion
(but only
rarely
required in
RD)
Decompensated
heterophoria
Not associated or
weak correlate,
but could rarely
contribute to RD
Symptoms,
aligning prism,
poor cover test
recovery, low
fusional reserves
(Table 3.2)
Spectacles,
eye exercises
Convergence
insufficiency
Not associated or
weak correlate,
but common &
could contribute
to RD
Remote near
point of
convergence,
Eye exercises,
(rarely
spectacles)
Binocular
instability
Moderate
correlate of RD.
May contribute to
RD
Low fusional
reserves,
unstable aligning
prism, unstable
heterophoria
(Table 3.2)
Eye exercises,
spectacles
Accommodative
anomalies
Weak correlate of
RD. May
contribute to RD
High
accommodative
lag
Low amplitude of
accommodation
Accommodative
infacility
Eye exercises,
spectacles
Table 3.3. Summary of the conditions discussed in this chapter and their
Chapter 3 Binocular vision and accommodative anomalies
69
relationship with reading difficulty (RD).
References
Vision, Reading Difficulties and Visual Stress
70
1. Creavin AL, Lingam R, Steer C, Williams C. Ophthalmic abnormalities and
reading impairment. Pediatrics. 2015;135(6):1057-65. doi:
10.1542/peds.2014-3622.
2. Hussaindeen JR, Shah P, Ramani KK, Ramanujan L. Efficacy of vision
therapy in children with learning disability and associated binocular
vision anomalies. Journal of Optometry. 2018;11(1):40-8. doi:
https://doi.org/10.1016/j.optom.2017.02.002.
3. Darvishi A, Rad DS, Atigh SBQ, Hamidi A, Shandiz JH, Baghini AS. The
relation between the severity of reading disorder and visual functions
among children with dyslexia. Taiwan J Ophthalmol. 2022;12(2):178-83.
doi: 10.4103/tjo.tjo_33_21.
4. Niechwiej-Szwedo E, Alramis F, Christian LW. Association between fine
motor skills and binocular visual function in children with reading
difficulties. Hum Mov Sci. 2017;56(Pt B):1-10. doi:
10.1016/j.humov.2017.10.014.
5. Evans B. Diagnosis of non-strabismic binocular vision anomalies - why
are there so many different approaches? Acta Ophthalmologica.
2024;102(S279). doi: https://doi.org/10.1111/aos.16094.
6. Evans BJW. Pickwell's Binocular Vision Anomalies. Sixth ed. Philadelphia:
Elsevier; 2021.
7. Evans BJW. Dyslexia and Vision. Chichester: Wiley; 2001.
8. Norn MS. Testing of dyslectic children by Jampolski's prism test. Acta
Ophthalmol (Copenh). 1969;47(5):1116-23.
9. Koklanis K, Georgievski Z, Brassington K, Bretherton L. The prevalence of
specific reading disability in an amblyopic population. A preliminary
report. Binocul Vis Strabismus Q. 2006;21(1):27-32.
10. Gitsels LA, Cortina-Borja M, Rahi JS. Is amblyopia associated with school
readiness and cognitive performance during early schooling? Findings
from the Millennium Cohort Study. PLOS ONE. 2020;15(6):e0234414. doi:
10.1371/journal.pone.0234414.
11. Ip JM, Robaei D, Rochtchina E, Mitchell P. Prevalence of Eye Disorders in
Young Children With Eyestrain Complaints. American Journal of
Ophthalmology. 2006;142(3):495-7.
12. Stifter E, Burggasser G, Hirmann E, Thaler A, Radner W. Monocular and
binocular reading performance in children with microstrabismic
amblyopia. Br J Ophthalmol. 2005;89(10):1324-9.
13. Tang STW, Evans BJW. The Near Mallett Unit Foveal Suppression Test: a
cross-sectional study to establish test norms and relationship with other
optometric tests. Ophthal Physiol Opt. 2007;27(1):31-43.
14. Wahlberg-Ramsay M, Nordstrom M, Salkic J, Brautaset R. Evaluation of
aspects of binocular vision in children with dyslexia. Strabismus.
2012;20(4):139-44. doi: 10.3109/09273972.2012.735335 [doi].
15. Quercia P, Quercia M, Feiss L, Allaert F. The distinctive vertical
heterophoria of dyslexics. Clinical ophthalmology (Auckland, NZ).
2015;9:1785-97. doi: 10.2147/OPTH.S88497.
16. Jainta S, Joss J. Binocular advantages in reading revisited: attenuating
Chapter 3 Binocular vision and accommodative anomalies
71
effects of individual horizontal heterophoria. J Eye Mov Res. 2019;12(4).
doi: 10.16910/jemr.12.4.10.
17. Karania R, Evans BJ. The Mallett Fixation Disparity Test: influence of test
instructions & relationship with symptoms. Ophthal Physiol Opt.
2006;26:507-22.
18. O'Leary CI, Evans BJW. Double-masked randomised placebo-controlled
trial of the effect of prismatic corrections on rate of reading and the
relationship with symptoms. Ophthal Physiol Opt. 2006;26(6):555-65.
19. Silbiger F, Woolf D. Fixation Disparity and reading achievement at the
college level. Am J Optom Arch Am Acad Opto. 2004;45(1):734-42.
20. Mohindra I, Scheiman MM. Fixation disparity and learning disabilities. B J
Physiol Opt. 1976;30:128-31.
21. Evans BJW, Drasdo N, Richards IL. Investigation of accommodative and
binocular function in dyslexia. Ophthal Physiol Opt. 1994;14(1):5-19.
22. Jenkins TCA, Pickwell LD, Yekta AA. Criteria for decompensation in
binocular vision. Ophthal Physiol Opt. 1989;9:121-5.
23. Yekta AA, Pickwell LD, Jenkins TCA. Binocular vision, age and symptoms.
Ophthal Physiol Opt. 1989;9:115-20.
24. Aziz S, Cleary M, Stewart HK, Weir CR. Are orthoptic exercises an
effective treatment for convergence and fusion deficiencies? Strabismus.
2006;14(4):183-9.
25. Evans BJW. Optometric prescribing in decompensated heterophoria.
Optometry in Practice. 2008;9(2):63-78.
26. Scheiman M, Denton C, Borsting E, Kulp M, Cotter S, Mitchell G, et al.
Effect of Vergence/Accommodative Therapy on Reading in Children with
Convergence Insufficiency: A Randomized Clinical Trial CITT-ART
Investigator Group. Optometry and Vision Science. 2019;96(11):836-49.
doi: 10.1097/OPX.0000000000001442.
27. CITT-ART Investigator Group. Treatment of Symptomatic Convergence
Insufficiency in Children Enrolled in the Convergence Insufficiency
Treatment Trial-Attention & Reading Trial: A Randomized Clinical Trial.
Optom Vis Sci. 2019;96(11):825-35. doi: 10.1097/opx.0000000000001443.
28. Daniel F, Kapoula Z. Induced vergence-accommodation conflict reduces
cognitive performance in the Stroop test. Scientific Reports.
2019;9(1):1247. doi: 10.1038/s41598-018-37778-y.
29. Kapoula Z, Bucci MP, Jurion F, Ayoun J, Afkhami F, Bremond-Gignac D.
Evidence for frequent divergence impairment in French dyslexic
children: deficit of convergence relaxation or of divergence per se?
Graefes Arch Clin Exp Ophthalmol. 2007;245(7):931-6.
30. Feizabadi M, Jafarzadehpur E, Akrami M. Accommodation, Convergence,
and Stereopsis in Dyslexic Schoolchildren. Middle East Afr J Ophthalmol.
2018;25(1):14-8. doi: 10.4103/meajo.MEAJO_71_17.
31. Granet DB, Gomi CF, Ventura R, Miller-Scholte A. The relationship
between convergence insufficiency and ADHD. Strabismus.
2005;13(4):163-8.
32. Raghuram A, Hunter DG, Gowrisankaran S, Waber DP. Self-reported
visual symptoms in children with developmental dyslexia. Vision Res.
2019;155:11-6. doi: 10.1016/j.visres.2018.11.007.
33. Burns DH, Evans BJW, Allen PM. Clinical measurement of amplitude of
accommodation: a review. Optometry in Practice. 2014;15(3):75-86.
34. Evans BJW. An open trial of the Institute Free-space Stereogram (IFS)
exercises. British Journal of Optometry & Dispensing. 2000;8(1):5-14.
35. Neuenschwander E, Rohrbach L, Schroth V. Changes in NPC in patients
with convergence insufficiency after IFS visual therapy. Optometry and
Contact Lenses. 2021;1(5):156-62.
36. Sheedy JE, Saladin JJ. Association of symptoms with measures of
oculomotor deficiencies. Am J Optom Physiol Opt. 1978;55(10):670-6.
37. Sheedy JE, Saladin JJ. Phoria, vergence, and fixation disparity in
oculomotor problems. Am J Optom Physiol Opt. 1977;54:474-8.
38. Scheiman M, Cotter S, Rouse M, Mitchell GL, Kulp M, Cooper J, et al.
Randomised clinical trial of the effectiveness of base-in prism reading
glasses versus placebo reading glasses for symptomatic convergence
insufficiency in children. Br J Ophthalmol. 2005;89(10):1318-23.
39. Dusek WA, Pierscionek BK, McClelland JF. An evaluation of clinical
treatment of convergence insufficiency for children with reading
difficulties. BMC Ophthalmol. 2011;11:21. doi: 1471-2415-11-21
[pii];10.1186/1471-2415-11-21 [doi].
40. Giles GH. The Practice of Orthoptics. London: Hammond, Hammond, &
Company; 1945.
41. Gibson HW. Binocular instability. Textbook of Orthoptics. London:
Hatton Press; 1955.
42. Evans BJW. Ophthalmic Factors in Dyslexia. Vision Sciences, Aston
University; 1991.
43. Evans BJW, Drasdo N, Richards IL. Dyslexia: the link with visual deficits.
Ophthal Physiol Opt. 1996;16(1):3-10.
44. Kapoula Z, Bucci MP. Postural control in dyslexic and non-dyslexic
children. J Neurol. 2007;254(9):1174-83.
45. Palomo-Alvarez C, Puell MC. Binocular function in school children with
reading difficulties. Graefes Arch Clin Exp Ophthalmol. 2010;248(6):885-
92. doi: 10.1007/s00417-009-1251-y [doi].
46. Bucci MP, Melithe D, Ajrezo L, Bui-Quoc E, Gerard CL. The influence of
oculomotor tasks on postural control in dyslexic children. Front Hum
Neurosci. 2014;8:981. doi: 10.3389/fnhum.2014.00981.
47. Quaid P, Simpson T. Association between reading speed, cycloplegic
refractive error, and oculomotor function in reading disabled children
versus controls. Graefes Arch Clin Exp Ophthalmol. 2013;251(1):169-87.
doi: 10.1007/s00417-012-2135-0 [doi].
Vision, Reading Difficulties and Visual Stress
72
48. Cornell ED, MacDougall HG, Predebon J, Curthoys IS. Errors in binocular
fixation are common in normal subjects during natural conditions.
Optom Vis Sci. 2003;80(11):764-71.
49. Bucci MP, Bremond-Gignac D, Kapoula Z. Poor binocular coordination of
saccades in dyslexic children. Graefes Arch Clin Exp Ophthalmol.
2008;246(3):417-28.
50. Cantonnet A, Filliozat J. Heterophoria. In. Strabismus. 1938:Second.
51. Francis EL, Jiang B, Owens DA, Tyrrell RA. Accommodation and vergence
require effort-to-see. Optom Vis Sci. 2003;80(6):467-73.
52. Jainta S, Kapoula Z. Dyslexic children are confronted with unstable
binocular fixation while reading. PLoS One. 2011;6(4):e18694. doi:
10.1371/journal.pone.0018694 [doi].
53. Kirkby JA, Blythe HI, Drieghe D, Liversedge SP. Reading text increases
binocular disparity in dyslexic children. PLoS One. 2011;6(11):e27105.
doi: 10.1371/journal.pone.0027105 [doi];PONE-D-11-10776 [pii].
54. Ward LM, Kapoula Z. Differential diagnosis of vergence and saccade
disorders in dyslexia. Sci Rep. 2020;10(1):22116. doi: 10.1038/s41598020-79089-1.
55. Temelturk RD, Ozer E. Binocular coordination of children with dyslexia
and typically developing children in linguistic and non-linguistic tasks:
evidence from eye movements. Ann Dyslexia. 2022;72(3):426-44. doi:
10.1007/s11881-022-00256-2.
56. Jimenez EC, Romeo A, Perez Zapata L, Sole Puig M, Bustos-Valenzuela P,
Canete J, et al. Eye vergence responses in children with and without
reading difficulties during a word detection task. Vision Res. 2020;169:6-
11. doi: 10.1016/j.visres.2020.02.001.
57. Przekoracka-Krawczyk A, Brenk-Krakowska A, Nawrot P, Rusiak P,
Naskrecki R. Unstable Binocular Fixation Affects Reaction Times But Not
Implicit Motor Learning in Dyslexia. Invest Ophthalmol Vis Sci.
2017;58(14):6470-80. doi: 10.1167/iovs.16-21305.
58. Cornelissen P, Bradley L, Fowler S, Stein J. What children see affects how
they spell. Developmental Medicine and Child Neurology. 1994;36:716-
27.
59. Cornelissen P, Bradley L, Fowler S, Stein J. Covering one eye affects how
some children read. Dev Med Child Neurol. 1992;34:296-304.
60. Cornelissen P, Bradley L, Fowler S, Stein J. What children see affects how
they read. Devel Med Child Neurol. 1991;33:755-62.
61. Gonzalez-Castro P, Rodriguez C, Nunez JC, Vallejo G, Gonzalez-Pienda JA.
Altered visual sensory fusion in children with reading difficulties. Percept
Mot Skills. 2014;119(3):925-48. doi: 10.2466/15.10.PMS.119c27z6.
62. Evans BJW, Wilkins AJ, Brown J, Busby A, Wingfield AE, Jeanes R, et al. A
preliminary investigation into the aetiology of Meares-Irlen Syndrome.
Ophthal Physiol Opt. 1996;16(4):286-96.
63. Evans BJW, Busby A, Jeanes R, Wilkins AJ. Optometric correlates of
Meares-Irlen Syndrome: a matched group study. Ophthal Physiol Opt.
Chapter 3 Binocular vision and accommodative anomalies
73
1995;15(5):481-7.
64. Jainta S, Jaschinski W, Wilkins AJ. Periodic letter strokes within a word
affect fixation disparity during reading. J Vis. 2010;10(13):2. doi: 10.13.2
[pii];10.1167/10.13.2 [doi].
65. Joss J, Jainta S. Do standard optometric measures predict binocular
coordination during reading? Journal of Eye Movement Research.
2021;13(6). doi: 10.16910/jemr.13.6.6.
66. Burns DH, Allen PM, Edgar DF, Evans BJW. Sources of error in clinical
measurement of the amplitude of accommodation. J Optom.
2020;13(1):3-14. doi: 10.1016/j.optom.2019.05.002.
67. Burns D, Allen P, Edgar D, Evans B. A Review of Depth of Focus in
Measurement of the Amplitude of Accommodation. Vision. 2018;2(3):37.
68. Allen PM, Dedi S, Kumar D, Patel T, Aloo M, Wilkins AJ. Accommodation,
pattern glare, and coloured overlays. Perception. 2012;41(12):1458-67.
69. Kiely PM, Crewther SG, Crewther DP. Is there an association between
functional vision and learning to read? Clin Exp Optom. 2001;84(6):346-
53.
70. Marran LF, De Land PN, Nguyen AL. Accommodative insufficiency is the
primary source of symptoms in children diagnosed with convergence
insufficiency. Optom Vis Sci. 2006;83(5):281-9.
71. Scheiman M, Mitchell GL, Cotter S, Rouse M, Borsting E, Kulp M, et al.
Accommodative insufficiency is the primary source of symptoms in
children diagnosed with convergence insufficiency. Optom Vis Sci.
2006;83(11):857-8. doi: 10.1097/01.opx.0000245513.51878.26
[doi];00006324-200611000-00015 [pii].
72. Brautaset R, Wahlberg M, Abdi S, Pansell T. Accommodation insufficiency
in children: are exercises better than reading glasses? Strabismus.
2008;16(2):65-9.
73. Rose J. Identifying and teaching children and young people with dyslexia
and literacy difficulties. Department for Education2009.
74. Stidwill D. Clinical survey: epidemiology of strabismus. Ophthal Physiol
Opt. 1997;17(6):536-9.
75. Long J, Cheung R, Duong S, Paynter R, Asper L. Viewing distance and
eyestrain symptoms with prolonged viewing of smartphones. Clinical
and Experimental Optometry. 2017;100(2):133-7. doi:
10.1111/cxo.12453.
Vision, Reading Difficulties and Visual Stress
74
Chapter 4
Controversial vision therapies
Chapter abstract
A wide range of treatments of reading difficulty have been proposed
and marketed, often with little appropriate evaluation. Several that
relate to vision are discussed in this chapter, including the training of
saccadic and pursuit eye movements, treatment of ocular dominance,
some elements of behavioural optometry, and cerebellar function
(balance) training. There are some followers for each of these methods,
but it is concluded the evidence does not support the widespread
adoption of these approaches.
Introduction
In Chapters 2 and 3 we discussed the relationship between reading
difficulty and common visual conditions that eyecare practitioners
investigate in everyday clinical practice. This chapter addresses the
visual factors that are not assessed in conventional sight tests and eye
examinations, but have been claimed to be correlated with reading
difficulty. For each of these factors, there are some clinicians or
researchers who argue that a significant proportion of children with
reading difficulties require treatment, often intensive vision therapy or
eye exercises, to correct the hypothesised anomaly.
Vision therapies tend to give the child a great deal of time and
attention and are therefore likely to generate a powerful placebo
effect. In Chapter 3, the CITT-ART trial
most thorough study to date of a programme of vision therapy, costing
8 million dollars and lasting 5 years.3 This study was not of a
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2024
A. J. Wilkins and B. J. W. Evans, Vision, Reading Difficulties and Visual Stress,
https://doi.org/10.1007/978-3-031-65568-5_4
1 2
was described which is the
75
controversial vision therapy, but rather evaluated mainstream eye
exercises for a widely recognised condition (decompensated near
exophoria associated with convergence insufficiency).4 Yet this study
found that, in terms of improving symptoms and reading, gold
standard vision therapy for this condition is no better than a placebo.
This is a salutary lesson: it is very easy for clinicians with the best of
intentions, to become convinced that a vision therapy is beneficial,
when in fact it may be the time and attention that underlies any
apparent improvement in symptoms or reading.
It was noted in Chapter 3 that families that deal with dyslexia have
many demands on their time and money and systematic teaching
programmes are a proven intervention. It is important that patients’
time and resources are used for these proven interventions rather
than those that are unproven.
Saccadic and pursuit eye movements
Background
The human retina is highly differentiated, with only the central fovea
possessing the structure required for detailed vision. Therefore, any
task that requires resolution of fine detail will require eye movements.
The most frequent movements of the eyes are saccades, when the eyes
flick from one point in the visual scene to another. Between saccades,
the eyes pause for a fixation, typically lasting about a quarter of a
second, during which information from the visual image is assimilated
and the eye alignment may be adjusted. The eyes then make another
saccade to the next fixation.
For those reading languages such as English, which are read from
left to right, most saccades during reading are from left to right, with a
Vision, Reading Difficulties and Visual Stress
76
large saccade at the end of each line when the eyes return to the
beginning of the next line. Sometimes, the eyes make a regression
saccade to return to re-fixate on some text that has already been read.
It is important to note that these eye movements are closely linked to
comprehension in a two-way flow of information. For example,
regressions are often necessitated by poor comprehension rather
a sign of an eye movement problem. If a person has trouble
understanding the text, they will make more regressions, returning to
previously read text to aid comprehension. These regressions are
sometimes described as “top-down” - eye movements reflecting
comprehension - rather than “bottom-up” (eye movements limiting
comprehension). Therefore, if the eye movements of a dyslexic
individual are recorded whilst they read, they are likely to be less fluent
and include more regressions. This does not mean that the eye
movements are abnormal, causing dyslexia, but rather that the less
fluid eye movements are the result of dyslexia.
than being
Saccades typically occur when scanning a complex stationary scene
or when watching rapidly moving targets. For example, when we look
at a picture, watch television, drive a car, search a crowd, or read then
our acquisition of information from the visual scene occurs via a
succession of saccades.
Pursuit eye movements are a less frequent form of eye movement,
used when viewing slowly moving targets. For example, a person
watching beginners playing a slow game of tennis may watch the ball
with pursuit eye movements. A spectator watching a professional
tennis match would find the ball moves too fast for the pursuit system,
requiring saccadic eye movements.
In the USA, optometrists typically describe saccadic and pursuit eye
movements as “oculomotor function”.5 Literally, oculomotor refers just
to the function of one of the three cranial nerves that control eye
Chapter 4 Controversial vision therapies
77