Aparna Raghuram, OD, PhD Optometrist, Department of Ophthalmology Instructor, Harvard Medical School

Visual Problems Common in Children with Dyslexia

MedicalResearch.com Interview with:

Aparna Raghuram, OD, PhD Optometrist, Department of Ophthalmology Instructor, Harvard Medical School

Dr. Raghuram

Aparna Raghuram, OD, PhD
Optometrist, Department of Ophthalmology
Instructor, Harvard Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Developmental dyslexia is a specific learning disability of neurobiological origin whose core cognitive deficit is widely believed to involve language (phonological) processing. Although reading is also a visual task, the potential role of vision has been controversial, and experts have historically dismissed claims that visual processing might contribute meaningfully to the deficits seen in developmental dyslexia.

Nevertheless, behavioral optometrists have for decades offered vision therapy on the premise that correcting peripheral visual deficits will facilitate reading. Yet there is a surprising dearth of controlled studies documenting that such deficits are more common in children with developmental dyslexia, much less whether treating them could improve reading.

In the present study, we simply assessed the prevalence and nature of visual deficits in 29 school aged children with developmental dyslexia compared to 33 typically developing readers. We found that deficits in accommodation 6 times more frequent in the children with developmental dyslexia and deficits in ocular motor tracking were 4 times more frequent.

In all, more than three-quarters of the children with developmental dyslexia had a deficit in one or more domain of visual function domain compared to only one third of the typically reading group.


MedicalResearch.com: What should readers take away from your report?

Response: Deficits in visual function appear to be far more common in school age children with developmental dyslexia, but the etiology and clinical relevance remains uncertain. Further study is needed to determine the extent to which treating these deficits can improve visual symptoms and/or reading parameters. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

  • Assuming the findings can be replicated, next steps would be to determine whether treating these visual deficits could have a positive impact on reading for these children with developmental dyslexia.
  • Since only a subset of children with developmental dyslexia had visual function deficits, it will be important to devise a screening protocol for psychologists, pediatricians, and reading specialists to help determine which children would benefit from a detailed visual function examination. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: This study did not demonstrate a causal role for visual function deficits in dyslexia, and more research is needed to determine whether this might be the case.

No disclosures.


Raghuram A, Gowrisankaran S, Swanson E, Zurakowski D, Hunter DG, Waber DP. Frequency of Visual Deficits in Children With Developmental Dyslexia. JAMA Ophthalmol. Published online July 19, 2018. doi:10.1001/jamaophthalmol.2018.2797

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Jul 20, 2018 @ 12:09 pm 

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  • Luqman Michel
    Posted at 07:21h, 24 July

    Vision divergence appears to be the new kid on the block for explaining why kids cannot read in English.

    In 2004 when I first started teaching children certified as dyslexic the theory was that kids could not read in English because of ‘Phonological awareness deficit.”. I challenged this theory in 2010 after teaching kids who could read in Malay and Pin Yin but not in English.

    A majority of kids who are classified as dyslexic are in fact instructional casualties.

    I have published a book ‘Shut down kids’ available on Amazon which explains why kids can read in many languages but not in English.

    My book is available on Amazon as well as on other on-line stores.

  • Dominick M Maino
    Posted at 14:35h, 23 July

    Therapy Boosts Reading for Kids with Convergence Insufficiency

    Biggest improvements found in children who responded early to treatment.
    Children with convergence insufficiency may be able to improve their reading skills through office-based vergence and accommodative therapy, according to a new study.

    The pilot study included 44 children between the ages of nine and 17 with symptomatic convergence insufficiency. The children were given four reading tests: the Wechsler Individual Achievement Test II; Test of Word Reading Efficiency; Test of Silent Word Reading Fluency; and the Gray Oral Reading Test. The tests were administered at baseline and eight weeks after participants completed a 16-week program of office-based vergence/accommodative therapy.

    After treatment, researchers noted a statistically significant improvement in reading comprehension and reading composite scores in the Wechsler Individual Achievement Test at 24 weeks. The study also reported the largest improvements occurred in participants who were early responders to treatment. Additionally, reading speed increased significantly on the Gray Oral Reading Test. Researchers found no significant improvements for single-word reading or reading fluency in the Test of Word Reading Efficiency, the Test of Silent Word Reading Fluency or the Gray Oral Reading Test.

    “The hypothesis is that for some children, there may not be a short‐term gain in reading, but after improved comfort as a result of successful therapy, some children may begin to read more often and subsequently show improvements in reading performance,” researchers said.

    Scheiman M, Chase C, Borsting E, et al. Effect of treatment of symptomatic convergence insufficiency on reading in children: a pilot study. Clin Exp Optom. 2018;101(4):585-93.