Optometrist Specialising in Children’s Learning Difficulties

Dorothy Crystal is a Specialist Optometrist working in this field. Yesterday about 16 of us (support for Learning teachers, health professionals) were priviliged to hear her talk passionately about her professional interest in children, optometry and learning difficulties.  I shall try to summarise!

In Norway all children with ASN are assesses by optomerist as there is a proven high correlation between learning difficulties and visual problems – 61%.  Hearing assessments follow on from this. 

Children may have problems with focussing, binocular vision and binocular instability.  The latter difficulty can be a big problem as information is processed differently.  Simple daily exercises can resolve these issues in 97% of cases! If a teacher thinks a pupils may be dyslexic then a vision check should be carried out first however it is important to alert the optomerist that the check is requested because of concerns about learning. Should the screening indicate a problem then the child can be referred on to either Dorothy Crystall or the Eye Pavilion.

Visual Stress is the new term to replace Myles Irlen or Scotopic Sensitivity.  It is diagnosed through a proper clinical process.  Children may be tested for this if there is a family history of migraine or epilepsy.  Assessment for coloured overlays used to treat visual stress, does incur a cost of £40. These overlays may only be required for 6 – 9 months

Children with astigmatic problems (wobbly eyes!) may sometimes invert letters in words. The incidence of this is increasing particularly in children of drug abusing mothers. Astigmatism will affect reading however larger print may help. If Astigmatism develops (rather than congenital) then there is a pathological reason, usually a brain tumour.

Teachers can look out for a variety of signs – child covers one eye to read, holds book at an angle, turns head at an angle when reading, rubs eyes , blinks a lot, fine and gross motor problems.  If a child frequently daydreams s/he may be trying to correct blurry images. The history and symptoms provide the biggest clues for the optomerist. When using an Interactive Whiteboard the child should be directly in front of it. Copying from the IWB is usually very difficult for the child.

And of course the earlier the better for assessment – from P1 onwards.

1 thought on “Optometrist Specialising in Children’s Learning Difficulties

  1. What a fascinating discussion we had!
    Here are 2 related news items I picked up from the ‘World of Dyslexia’ newsletter:
    Wilkins Intuitive Overlays – Cerium Overlays are colored sheets of robust transparent plastic which can be used for all reading tasks. The use of an overlay has been shown by Professor Arnold Wilkins at the Medical Research Council at Cambridge, UK, to enable an increase in reading fluency, efficiency and duration. The same research also demonstrated that the color selected will vary for each child.
    In the past assessment for scotopic sensitivity was generally done by the Irlen Institute. It was quite an expensive assessment and the overlays were also relatively expensive. Now the Intuitive Overlays Test has enabled practitioners who have been trained by the Institute of Optometrists to carry out an assessment and prescribe an overlay for use when reading.

    Are Weak Eye Muscles Holding Your Child Back at School?
    There are all sorts of reasons for learning difficulties, but for some children – perhaps as many as 400,000 in the UK – the problem lies with the way their eyes work. If the muscles around the eyes are weak, the eyes won’t work as a co-ordinated pair. This makes it difficult to focus clearly on something as small as the printed words on a page. Now a new campaign has been launched to alert parents and teachers to the fact that sight problems can be an issue for children with dyslexia and other learning difficulties. The good news is treatment from an orthoptist, an eye specialist who deals with focusing problems, could improve their vision dramatically.

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