Vision And Learning

Vision And Learning

What about Vision and Learning

Vision is the process of deriving meaning from what is seen and is a fundamental factor in the learning process.

There are three inter-related areas of visual function.

  1. Visual pathway integrity including eye health, clarity of sight and refractive status;
  2. Visual efficiency including accommodation (focusing), binocular vision (eye teaming) and eye movement control (tracking);
  3. Visual information processing including spatial awareness, identification and discrimination, and integration with other senses.

Learning related vision problems can only be identified by a comprehensive evaluation of each of these aspects of visual function. Vision is not entirely innate but continues to develop after birth and is influenced by the visual environment and the individual’s experience.

If a person’s visual system has not developed to its optimal level, visually demanding activities may lead to inefficient or uncomfortable vision. Good visual acuity (clarity of sight) and healthy eyes are no assurance that an individual does not have a vision problem.

Learning is accomplished through complex and inter-related processes, one of which is vision. Determining the relationships between vision and learning involves more than evaluating eye health and visual acuity. Problems in identifying and treating people with learning-related vision problems arise when such a limited definition of vision is employed.

The purpose of optometric intervention in the management of children and adults with learning disabilities is to eliminate any vision problem which may obstruct learning.
Educational, neuro-psychological and biological research has suggested distinct subtypes of learning difficulties. Current research indicates that some people with reading difficulties have coexisting visual and language processing deficits. For this reason, no single treatment, profession or discipline can be expected to adequately address all of their needs.


  1. Vision problems can and often do interfere with learning.
  2. People at risk for learning-related vision problems should be evaluated by an optometrist who provides diagnostic and management services in this area.
  3. The goal of optometric intervention is to improve visual function and alleviate associated signs and symptoms.
  4. Prompt remediation of learning-related vision problems enhances the ability of children and adults to perform to their full potential.
  5. People with learning problems require help from many disciplines to meet the learning challenges they face.

Comprehensive Visual Exam

A comprehensive vision evaluation includes an assessment of:

1. Visual pathway integrity including eye health, visual acuity and refractive status (for example, longsightedness, astigmatism).

2. Visual efficiency including accommodation (focussing), binocular vision (eye alignment and teaming).

3. Visual information processing including visual spatial skills (right/left discrimination), visual analysis skills (matching and discrimination skills), visual motor skills (required for drawing and handwriting), eye movement control skills and visual imagery skills. Treatment strategies may include the prescription of spectacles for part time, or sometimes full time wear. Advice may be given on how to adapt the environment and alter work habits to reduce the load on the visual system. Vision therapy may be prescribed to aid visual efficiency and/or visual information processing.

4. Referral to another professional may be an adjunctive or the sole outcome of the optometric evaluation. The expected outcome of optometric intervention is an improvement in visual function with the reduction of associated signs and symptoms.

5. While optometric intervention does not directly treat learning or reading difficulties, it does address physical and developmental barriers to learning, and so renders the affected individual more amenable to educational remediation.

6. The earlier the problem is addressed the better the long term results usually are.

Vision, Learning & Dyslexia

Much of the way we learn, both at school and in the workplace, is by reading printed information. While learning itself is accomplished by the interaction of many different processes and skills, processing of visual information (books, newspapers, manuals, e-mail and websites, to name a few) is a major player, indeed the dominant player, in the acquisition of information.

There is currently much concern in the community regarding the level of literacy skills, probably because advances in information technology have increased the demands placed on people to wade through the plethora of written information presented to them each day. As such it is important that the issues regarding vision and learning are well understood by the community, schools and health professionals.

In this way optometry can be of optimal help. Not all children with learning problems will have visual difficulties. Likewise, not all children with visual difficulties will be classified as educationally delayed. Even if an optometrist diagnoses an individual with a visually-related learning difficulty, it would not be uncommon for other factors also to be contributing to that learning profile. That is, in some instances the visual problems may be primary in the development of the reading or learning difficulty, but more frequently they are contributory.

As such optometrists work together with other professional disciplines and believe in a multidisciplinary approach to evaluating an individuals learning difficulties. First we should define what we mean by dyslexia and reading difficulties. Most experts would agree that it relates to about 10% of children who exhibit a learning problem. Their difficulties are usually language based and the cause is obscure. Individuals with reading difficulties may be experiencing difficulty in ‘learning to read’ or may have learnt to read but experience difficulty in ‘reading to learn’.

Perhaps the individual lacks concentration or comprehension, or is slow to complete the task, or experienced headaches or sore eyes. Perhaps a child is slower than expected to learn the letters of the alphabet or fatigues easily or has messy handwriting. Perhaps the child is performing satisfactorily academically, yet not as well as expected. All of these cases suggest a vision examination is required. Individuals with learning problems should receive a comprehensive optometric evaluation. We recommend that children undergo an visual assessment at 6 months of age, at 3.5 years or age and again in the first year of school, the third year of school, the final year of primary school and in the last year or two of high school. This covers the major times in life when the eyes change or when the visual demands on the individual changes. Once school is finished your optometrist will advise when the next assessment is due.


  1. Solan HA Dyslexia and learning disabilities: An overview. Optometry and Vision Science, Vol 70, No5,pp343-347.
  2. Simons HD An analysis of the role of vision anomalies in reading interference. Optometry and Vision Science. Vol 70, No5, pp369-373.
  3. Flax N. The contributions of visual problems to learning disability. J Am Optom Assoc 41: 841-5, 1970.
  4. Farr and Leibowitz An experimental study on the efficacy of perceptual-motor training. American Journal of Optometry and Physiological Optics. Vol 53, No 9 Part 1 September 1976.
  5. The efficacy of optometric vision therapy. A special report. Journal of the American Optometric Association. Vol 59, No 2, 2/1988.
  6. Scheiman MM and Rouse MW (eds): Optometric management of learning related vision problems. St Louis: CV Mosby, 1994: 127-52.
  7. Seiderman AS Optometric vision therapy- results of a demonstration project with a learning disabled population. J Am Optom Assoc 51: 489-493, 1980.
  8. Halliwell JW, Solan HA: The effects of a supplemental perceptual training program on reading achievement. Exceptional Child 38: 613-2, 1972.
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