The first step with any child is to have a full eye examination which is free of charge to you, being paid for by the NHS. This will check if there is any need for glasses or ocular health issues that could explain any visual difficulties. A child with difficulties who is found to have no significant refractive error (glasses prescription) or who presents with classic symptoms of specific learning difficulties such as “words jumping on the page” may then be recommended for further assessment. This further appointment is not covered by the NHS, and private fees will apply.
There are 2 types of assessment which we can carry out, which are designed to investigate in further depth if there are any visual factors which may be contributing to a child’s difficulties. The first is related to how well the two eyes are being used together and the second is for Meares-Irlen syndrome. Depending on the results of our initial investigations, we may recommend investigation of either or both of these things.
When evaluating how well the two eyes are being used together, your optometrist will concentrate on the co-ordination of the two eyes (binocular vision). Muscle weaknesses or strain found by these tests can certainly contribute to difficulty in sustaining focus when reading. They will also check your child’s ability to focus on near objects in order to make text clear (accommodate). Should any of these tests find areas of weakness, then simple eye exercises may be issued for your child to perform at home.
Your child can also be assessed for “Meares-Irlen Syndrome” which is certain sensitivity for colour where using a prescribed coloured overlay increases the speed of reading. A recent study found that about 20% of subjects found a decrease in symptoms of eyestrain and headache when using a coloured overlay.
Should your child demonstrate an improvement whilst using their selected individual overlay then a specific coloured A5 sheet will be issued. The child should never be forced to use the overlay, as voluntary use of the overlay may be evidence in itself that it is helping. As well as the use of overlays, it is possible to arrange for your child to read their computer screen with the equivalent coloured overlay or they may prefer to have glasses with tinted lenses. These can be supplied either as a ‘clip-on’ for any existing glasses or made specifically in your child’s prescription.
Following your child’s examination a full report will be provided for your reference and, with your consent, another report may be sent to your child’s appropriate teacher so they are fully aware of our findings and recommendations. Most children are recommended to return 6-8 weeks after their initial assessment, when the results of exercises will be investigated and the effect of using the overlays discussed.
Research has shown that around 20% of children suffer from varying degrees of visual stress. Visual stress is a disturbance in the link between the back of the eye and the brain and is common after reading for long periods of time. Visual stress is often more common in children with specific learning difficulties.
If your child avoids reading, finds it difficult to follow text along a line or finds words look blurred or jump around the page, then you should contact us for further advice.
Specifically coloured overlays or tinted lenses can help with the symptoms of visual stress and improve the attention strong when reading.
You should be aware that recent studies into improvements in reading performance achieved when using coloured overlays have shown that this may be due to Placebo effect.
We are not able to diagnose a specific learning disability. Our job is to try and find any visual factors which may be contributing to a child‘s difficulties. Our role is to work as part of a multi-disciplinary team with your child‘s teachers and educational psychologists.
There are many other vision training / tests available but currently there is lack of scientific evidence to support them. You should discuss any concerns you have with your child’s teachers to consider other possible areas of support. For instance Phonics instruction may provide improvements in reading.