-
My child just started school and has difficulty in recognising words. The
school psychologist said he has dyslexia. Is this condition due to an eye
problem?
-
Who should manage my
child’s reading problem?
-
What is the role of the ophthalmologist in the management of developmental
dyslexia?
-
What
are the effective treatments for developmental dyslexia?
-
My child is currently wearing tinted glasses. Will this improve his
condition?
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How do I get
more information?
My child just started school and has difficulty in recognising words. The
school psychologist said he has dyslexia. Is this condition due to an eye
problem?
“
Developmental dyslexia” is a difficulty in reading in children and adults, at
the level that would be expected with their home background, educational
opportunities, motivation, and intelligence.
Children with this condition, despite being above normal intelligence, may have
had difficulties with writing letters and recognizing words since beginning
school. They may show poor concentration in the classroom, disruptive
behaviour, untidy writing, poor spelling, and they may have fallen significantly
behind in reading by the time they are seven or eight. Dyslexia is a very
difficult problem for the child, parents, and teachers alike. Since children
with dyslexia often have normal or superior intelligence, the teachers and
parents often consult an ophthalmologist to look to visual defects that may
result to poor reading. The truth is that there is no evidence supporting a
relationship between visual disabilities and reading problems.
Studies
have consistently shown that normal readers and patients with dyslexia have
similar incidences of visual defects. Children with learning disabilities have
the same incidence of ocular abnormalities as children who are normal achievers
and are reading at grade level. The treatment of visual problems, when present,
may lead to some improvement in the reading ability of the child with
developmental dyslexia but it is extremely unlikely to lead to a cure.
Even
though the majority of children with dyslexia will have normal ophthalmologic
examinations, they should have a complete eye examination, including dilating
drops for a cycloplegic refraction. Convergence insufficiency and hypermetropia
are conditions that may interfere with reading and lead to near fatigue and
asthenopia, yet are not easily detected by routine screening examinations
performed in school.
The
defect in developmental dyslexia lies within the brain and its processing of
visual stimuli. The misunderstanding as to the nature of this condition has led
to many myths as to its etiology and to controversial therapies.
To
summarize, the following are the key features of developmental dyslexia:
-
It is due to a
linguistic defect and not to a visual problem
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It is not
related to intelligence
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Boys and girls
are equally affected
-
Persist into
adulthood, but most children are able to be taught to read accurately even
though they tend to read more slowly and not automatically
-
Early
diagnosis and remedial intervention is the only scientifically proven therapy
-
Therapies not
based on a linguistic process remain controversial
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Who should manage my
child’s reading problem?
The
treatment of developmental dyslexia entails a multidisciplinary approach. The
following professionals will work as a team in dealing with this condition:
-
Ophthalmologist corrects any ocular problem that could interfere with reading
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Educational
psychologist confirms the diagnosis and assesses the child’s reading ability
-
Pediatrician/general
practitioner manages any physical problem
-
Remedial
teacher provides the therapy
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What is the role of the ophthalmologist in the management of developmental
dyslexia?
The
role of the ophthalmologist is to address any eye problem. The consultation is
generally time-consuming because a series of specific ophthalmologic examination
shall be performed. A great amount of time shall be spent on explanation of the
role of the eyes in reading and developmental dyslexia, and discussion of
controversial and non-controversial therapies.
The
following are the specific ophthalmological examination that will be undertaken
in the clinic:
The eye
examination in most children will be normal. If problems are detected relating
to ocular muscle imbalance, weakness of convergence or accommodation, or a
significant refractive error, these need to be corrected.
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What are
the effective treatments for developmental dyslexia?
Early
diagnosis of developmental dyslexia based on a comprehensive evaluation by a
skilled educational psychologist will allow the child with developmental
dyslexia to gain the maximum benefit from remedial intervention. The diagnosis
of developmental dyslexia is reached through an extensive evaluation that
involves not only assessment of reading ability, but also assessment of
intelligence. Prior to embarking on a remedial program, there is also a need to
exclude any sensory deficit involving vision and hearing. The pediatric
ophthalmologist will address all the eye-related problems such as visual
impairment, refractive errors, abnormal eye movements, and convergence
insufficiency. Glasses and eye muscle exercises shall be provided if
necessary. A referral to an ENT specialist is advisable to rule out any hearing
impairment.
The
only form of therapy for developmental dyslexia that has been consistently shown
to have results is remediation. To learn to read, all children must
discover that spoken words can be broken down into units of sound, phonemes.
Children with dyslexia do not easily acquire the basic phonologic skills that
serve as a prerequisite to reading. In these children phoneme awareness is
taught with systemic and highly structured training exercises.
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My child is currently wearing tinted glasses. Will this improve his
condition?
Parents
of children with developmental dyslexia are often on the lookout for any form of
therapy that will “cure” or “correct” the problem quickly. The use of these
controversial therapies results in unwarranted expense and often misplaces
resources when they could be better used for reading education and tutors.
A
treatment approach can be considered controversial if the approach is proposed
to the public before any research is available or preliminary research has bot
been replicated; the proposed approach goes beyond what research data support;
or the approach is used in isolation when a multimodal approach is needed.
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Vision training: Vision training was popularized by behavioural
optometrists, based on the premise that reading is primarily a visual task.
It is proposed to change specific visual function, such as convergence,
accommodation, ocular motility, and the range and quality of binocular
function. It involves eye muscle exercises, ocular pursuit and tracking
exercises. Evidence does not support the claim that vision training improves
reading. Although ophthalmologists and behavioural optometrists disagree on
the value of vision training, there is agreement that if a child has
developmental dyslexia, it is critical to rule out the presence of any
refractive errors, problems with convergence and accommodation, and strabismus
and to treat these appropriately.
-
Applied kinesiology: This form of chiropractic treatment for developmental
dyslexia is not based on any known research.
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Anti-motion sickness medication: There is no evidence to support that
giving anti-motion sickness medication to treat vestibular dysfunction in
children with learning disabilities.
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Syntonics: Syntonics, or color vision therapy, has been used to treat
several conditions including myopia, strabismus, amblyopia, headache, visual
fatigue, reading problems, and general binocular dysfunction. The published
data do not provide convincing support for the claims of therapeutic successes
for reading disability with the use of syntonics.
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Tinted lenses: No evidence supports the therapeutic benefit of using
tinted lenses in developmental dyslexia.
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Megavitamins and omega oils: No research to support the usefulness of
megavitamins and omega oils in developmental dyslexia.
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Trace elements: No research to support the usefulness of megavitamins and
omega oils in developmental dyslexia.
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Psycho stimulants: Methylpenidate (Ritalin) and Dexamphetamine (Dexedrine)
have been reported as helping children with developmental dyslexia. These
medications improve symptoms of attention deficit disorder (ADD) that may
coexist with developmental dyslexia, and make the child more compliant in the
classroom. The improvement in concentration improves the ability to respond
to instruction and teaching. They do not have any direct effect on
developmental dyslexia.
There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
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Surgery Resource
http://www.Glaucoma.com.ph - Glaucoma
Online
http://www.Uveitis.com.ph - Uveitis Online
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EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
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EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
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Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
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Medical City
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EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
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Philippines
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DYSLEXIA information
compiled by Dr.
Barbara L. Roque and initially uploaded on June 1, 2005.
Last updated on
September 13, 2007. |
