Search

Visual factors in specific learning difficulties (SpLD) are reviewed. People with SpLD fail to achieve at a level that is commensurate with their intelligence. The commonest SpLD is dyslexia, which usually results from phonological processing/decoding deficits. Additionally, there are several optometric correlates of SpLD which may, in some cases, contribute to the learning difficulty. These correlates include binocular instability and a low amplitude of accommodation. Some people with reading difficulties and perceptual distortions/eyestrain can be helped by individually prescribed coloured filters. A visual processing anomaly is also often present in the form of a deficit of the transient visual system. The role of the optometrist is discussed.

Some research reports suggest that visual anomalies may have a causative role in dyslexia, and on this basis certain forms of therapy have been proposed. Recently, we have published the initial results of a matched group study which found dyslexia to be associated with binocular instability, reduced amplitude of accommodation, and reduced contrast sensitivity for both low spatial frequencies and uniform field flicker. The binocular instability was best identified by measuring the vergence amplitude: a modified Dunlop test failed to differentiate reliably between the two groups. Here, we report a significant correlation between flicker threshold and binocular instability, thus linking sensory and motor visual correlates of dyslexia. We also present further new analyses on the interaction between optometric variables and the psychometric measurement of coding skills. The results of these analyses disagree with a recent claim that binocular vision anomalies might cause poor performance at coding tasks. Our studies indicate that visual characteristics are not the major aetiological factors in specific reading difficulty.

Scotopic sensitivity syndrome or the Irlen syndrome describes symptoms of asthenopia anamolous visual performance experienced while reading that are lessened by colored filters. One putative explantation for this condition relates to pattern glare: a hypersensitivity to repetitive patterns, including lines of print on a page. Experiment 1 used a placebo-controlled paradigm to investigate the effect of pattern glare and colored overlays on performance at a simulated reading visual search task. Despite the fact that the subjects were university students, the results showed a tendency, of border-line significance, to support the conclusion that colored filters seem to improve reading through ameliorating pattern glare. In experiment 2 we compared the prevalence of pattern glare in matched groups of dyslexic children and good readers. The dyslexic group reported more pattern glare, but also reported more glare from a control stimulus. Pattern glare in the dyslexic group was directly correlated with flicker sensitivity. The results are related to recent research on visual processing and ocular-motor function in dyslexia.

The role of visual factors in dyslexia has been a long-standing source of controversy. Recent research has suggested that there may be a deficit of the transient visual subsystem in dyslexia. The evidence for this hypothesis comes principally from investigations of spatial and temporal contrast sensitivity and visual persistence. This evidence is reviewed and it is noted that previous work has never applied two of these purported "tests of transient function" to the same subject group. The hypothesised transient system deficit in dyslexia was investigated in a study comparing 43 control with 39 dyslexic children who were matched for age, sex, and intelligence. Comprehensive psychometric and optometric data were obtained, including visual acuities and refractive errors. The spatial contrast sensitivity function was determined in such a way as to investigate further the findings of Lovegrove, Martin, Bowling, Blackwood, Badcock and Paxton [(1982) Neuropsychology, 20, 309-315] and Martin and Lovegrove [(1984) Neuropsychologia, 22, 73-77]. It might be expected, from the work of Merigan and Maunsell [(1990) Neuroscience, 5, 347-352], that a better test of magno-cellular function would be to investigate the modulation threshold for a virtually uniform field that was flickering sinusoidally at 10 Hz. This temporal contrast sensitivity was studied in a similar way to Brannan and Williams [(1988) Clinical Vision Sciences, 3, 137-142]. A non-verbal simulated reading visual search task was used to investigate the effect of any visual deficits on a test that was, in its low-level visual requirements, similar to reading. The following factors were found to be significantly associated with dyslexia: reduced visual acuity, impaired flicker detection at 10 Hz, reduced low spatial frequency contrast sensitivity, and slightly slower performance at a simulated reading visual search task. The two alleged "tests of transient function" were only weakly correlated with one another (r = 0.183), suggesting that these variables do not measure the same function. Much of the dyslexic group's slightly slower performance at the simulated reading task could be accounted for by the psychometric variable of visual sequential memory. Like reading, the simulated reading task requires the accurate perception of sequential characters. Hence, it seems unlikely that the low-level visual deficits in the dyslexic group were major causes of their poor reading performance. Alternative explanations for the results are discussed.

Dyslexia and the effect of visual problems on reading ability have long been subjects of controversy. This paper critically reviews the literature on the relationship between reading disability and visual acuity, refractive error, binocular vision anomalies, eye movements, ocular pathology and the transient and sustained visual systems. The limitations of much of the work in this field are described, with particular reference to the problems of subject selection and group matching. Tentative conclusions, with deference to the complex nature of dyslexia, are drawn and suggestions are made for future research.

Pattern glare is characterised by symptoms of visual perceptual distortions and visual stress on viewing striped patterns. People with migraine or Meares–Irlen syndrome (visual stress) are especially prone to pattern glare. The literature on pattern glare is reviewed, and the goal of this study was to develop clinical norms for the Wilkins and Evans Pattern Glare Test. This comprises three test plates of square wave patterns of spatial frequency 0.5, 3 and 12 cycles per degree (cpd). Patients are shown the 0.5 cpd grating and the number of distortions that are reported in response to a list of questions is recorded. This is repeated for the other patterns. People who are prone to pattern glare experience visual perceptual distortions on viewing the 3 cpd grating, and pattern glare can be quantified as either the sum of distortions reported with the 3 cpd pattern or as the difference between the number of distortions with the 3 and 12 cpd gratings, the ‘3–12 cpd difference’. In study 1, 100 patients consulting an optometrist performed the Pattern Glare Test and the 95th percentile of responses was calculated as the limit of the normal range. The normal range for the number of distortions was found to be <4 on the 3 cpd grating and <2 for the 3–12 cpd difference. Pattern glare was similar in both genders but decreased with age. In study 2, 30 additional participants were given the test in the reverse of the usual testing order and were compared with a sub-group from study 1, matched for age and gender. Participants experienced more distortions with the 12 cpd grating if it was presented after the 3 cpd grating. However, the order did not influence the two key measures of pattern glare. In study 3, 30 further participants who reported a medical diagnosis of migraine were compared with a sub-group of the participants in study 1 who did not report migraine or frequent headaches, matched for age and gender. The migraine group reported more symptoms on viewing all gratings, particularly the 3 cpd grating. The only variable to be significantly different between the groups was the 3–12 cpd difference. In conclusion, people have an abnormal degree of pattern glare if they have a Pattern Glare Test score of >3 on the 3 cpd grating or a score of >1 on the 3–12 cpd difference. The literature suggests that these people are likely to have visual stress in everyday life and may therefore benefit from interventions designed to alleviate visual stress, such as precision tinted lenses. [ABSTRACT FROM AUTHOR]

A recent double-masked placebo-controlled trial has confirmed that some children experience a reduction in symptoms of eyestrain and headache when they read through individually prescribed coloured filters and has shown that this benefit cannot be solely attributed to a placebo effect. People who are helped by coloured filters in this way have been described as having 'Meares-lrlen syndrome'. We investigated the mechanism of this benefit by studying the optometric and visual perceptual characteristics of the children in the double-masked study. This population had normal refractive errors and heterophorias (none of the subjects had strabismus). They demonstrated slightly, but significantly, reduced amplitudes of accommodation and vergence and poor stereo-acuity. However, these factors seemed to be correlates of Meares-lrlen syndrome rather than the underlying cause. Pattern glare, a sensitivity to striped patterns (e.g. lines of text), was prevalent in our sample and was significantly associated with the subjects' symptoms. The spatial contrast sensitivity function was normal. Copyright © 1996 The College of Optometrists. Published by Elsevier Science Ltd [ABSTRACT FROM AUTHOR]

Dyslexia has conventionally been attributed to a left hemisphere deficit affecting language skills. However, it has recently been suggested that two-thirds of dyslexic people have a lesion of the right posterior parietal lobe (RPPL) resulting in poor oculo-motor control. It has been reported that neurological patients with RPPL lesions commonly manifest a neglect of the left side of space and this has also been described in clinical observations of 'visual dyslexies'. We investigated this hypothesis with a sample of 53 dyslexic children and 53 controls using a line-bisection task. In the horizontal test condition both groups tended to transect slightly to the left of the midpoint (mean displacement 0.14 mm for controls; 0.4 mm for dyslexies). The result suggests a small right side neglect which, contrary to one report in the literature, is found here in developmental dyslexies as well as controls, and leads to the conclusion that RPPL lesion is unlikely to be a common feature of dyslexia. [ABSTRACT FROM AUTHOR]