Eyecare Related Questions, Answered for You
FOR PARENTS & TEACHERS
PARENTS: HAS YOUR CHILD BEEN DIAGNOSED WITH ADHD?
Did you know that, in one study, in a group of children who had been diagnosed with convergence insufficiency, 13 percent of their parents reported a diagnosis or self-evaluation of ADHD in the child? Did you know that, in this same study, with a group of children evaluated as not having convergence insufficiency, only 6 percent of their parents reported likewise? There seems to be a certain degree of correlation between vision disorders and ADHD symptoms, either caused by co-incidence of the disorders or, possibly, by the vision disorder causing some of the ADHD-like symptoms.
We would never claim that we can cure ADHD, but could it be that your child, who has been diagnosed with ADHD, has a vision problem which is either causing or exacerbating the disorder? Wouldn’t you like to see some permanent improvement in your child? If so, we believe that a comprehensive eye exam may provide some of the answers that you are seeking. If we find incidence of convergence insufficiency or other vision disorder, a series of vision therapy procedures could help your child manage their ADHD symptoms more effectively. In some instances, we have even seen ADHD symptoms be eliminated completely when the vision problem is corrected.
TEACHERS: DO YOU HAVE PROBLEM LEARNERS IN YOUR CLASSROOM?
It’s hard to be a teacher: Some students don’t care to learn the material you are trying to teach, and others have learning disabilities or vision disorders which impair their ability to focus or understand. How do you teach such students? Obviously, those students with ADHD probably are receiving treatment for it, which allows you to hold their attention for some amount of time, but what happens if the parent forgets to fill the prescription?
Worse still, many learning disorders go untreated or are improperly treated. Vision disorders can affect a child’s ability to learn, especially since most of the learning in the modern classroom is accomplished visually. The pandemic showed us the strain of learning via computer, as a lot of kids struggled during 'online learning that tried to replace the classroom during the shutdown.
A vision disorder often manifests itself in ways which can be mistaken for ADHD, such as a reluctance to read or trouble focusing on close work for more than a few minutes at a time. If you suspect that a child has an undiagnosed learning or vision disorder, it may be worthwhile to recommend to the child’s parents that they schedule a visit with a developmental optometrist for a comprehensive eye exam. This way, a vision disorder can be properly eliminated from the bank of possibilities before suggesting that the child is suffering from a learning disability such as ADHD.
VISION DISORDERS CAUSE ADHD OVER-DIAGNOSIS
We believe that ADHD is a real disorder that suffers from an over-diagnosis problem, and we believe that teachers and parents can work together to address the visual problems which may be causing ADHD-like symptoms. This could reduce or eliminate the ADHD-like symptoms, thus reducing or eliminating the amount of medication that the child must be on in order to function in a learning environment. Call Dr. Geoff Heddle today for more information about vision disorders and vision therapy, or to schedule a comprehensive vision exam.
ABSTRACT
Background: Children being evaluated for attention deficit hyperactivity disorder (ADHD) often have an eye exam as part of their evaluation. The symptoms of convergence insufficiency (CI) can make it difficult for a student to concentrate on extended reading and overlap with those of ADHD.
Methods: A retrospective review of 266 patients with CI presenting to an academic pediatric ophthalmology practice was performed. All patients included were diagnosed with CI by one author (DBG) and evaluated for the diagnosis of ADHD. A computerized review was also performed looking at the converse incidence of CI in patients carrying the diagnosis of ADHD.
Results: We reviewed 266 charts of patients with CI. Twenty-six patients (9.8%) were diagnosed with ADHD at some time in their clinical course. Of the patients with ADHD and CI, 20 (76.9%) were on medication for ADHD at the time of diagnosis for CI while 6 (23.1%) were either not on medication or the medication was discontinued several months before the diagnosis of CI. The review of computer records showed a 15.9% incidence of CI in the ADHD population.
Conclusion: We report an apparent three-fold greater incidence of ADHD among patients with CI when compared with the incidence of ADHD in the general US population (1.8-3.3%). We also note a seeming three-fold greater incidence of CI in the ADHD population. This may simply represent an association and not be a causative relationship. Until further studies are performed, however, patients diagnosed with ADHD should be evaluated to identify the small subset that may have CI -- a condition that responds well to treatment at home.