Learning-related Vision Problems

Learning-related vision problems represent deficits in two broad visual system components: visual efficiency and visual information processing. Learning-related vision problems comprises the basic visual physiological processes of visual acuity (and refractive error), accommodation, vergence, and ocular motility. Learning-related vision problems involves higher brain functions including the non-motor aspects of visual perception and cognition, and their integration with motor, auditory, language, and attention systems.

During pre-school and the early school years, academic instruction places relatively greater demand on a child’s visual information processing skills.59 There is an emphasis on recognition, matching, and recall. Periods of sustained near work are infrequent, and visual stimuli (i.e., letters) are relatively large and widely spaced. Learning-related vision problems become relatively more significant later in the educational process. Reading demands increase with the need to achieve grade-appropriate rates of reading with comprehension (fluency) over more extended periods of time, when letters and text become smaller and more closely spaced. Equally, this increase in sustained periods of near work becomes a significant risk factor for the development of visual efficiency problems. Demands for reading and writing fluency create a requirement for efficient and well-timed visual information processing.

Learning related vision problems comprise deficits in visual efficiency and visual information processing that have potential to interfere with the ability to perform to one’s full learning potential. Learning-related vision problems may cause clinical signs and symptoms that range from asthenopia and blurred vision to delayed learning of the alphabet, difficulty with reading and spelling, and skipping words and losing place when reading.

Vision related learning problems have a relatively high prevalence in the population. Learning-related vision problems respond favorably to the appropriate use of lenses, prisms, and vision therapy, either alone or in combination. Vision therapy is usually conducted in-office, and home support activities are prescribed.

The goal of optometric intervention is to improve visual function to the appropriate level. The diagnosis of a learning related vision problem must be accurate and thorough. It is likewise essential that the optometrist discuss the diagnosis with the parents or caregivers, and the patient, communicate with other professionals as required, and develop a management plan. Optometric intervention of Learning-related vision problems should be coordinated with other education and health professionals’ management of the associated learning problem, to ensure the maximum opportunity for improvement.