Visual
Dyslexia
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It has long been evident
that visual performance is a major factor in the presence of Dyslexia and
Dyspraxia. Dyslexics invariably report that lines of print, numbers or music
appear “jumbled up” and young Dyslexics usually display letter reversal of b’s
and d’s or inversion of f’s and t’s when learning to write. Those who suffer from this condition
invariably have difficulty with left and right decision making.
The Meares-Irlen
Syndrome was described in the 1980’s defining the visual component of Dyslexia
and the relation of associated reading difficulties with the differing colours
of text and more importantly background colour.
One of the first actions
taken in the diagnosis and treatment of a suspected Dyslexic should be a full
Eye Examination by a professional Optometrist known to be “Dyslexia
Friendly” i.e. having an interest in
and sympathetic to the problems of Dyslexics. The Optometrist will firstly
eliminate any clear clinical problems such as the presence of uncorrected
refractive error (short-sight, long-sight or astigmatism), the presence of eye
muscle defects including squint, or medical eye problems. The presence of any
of these could inhibit learning and so correction or treatment must be
initiated.
Once clinical eye
problems are eliminated then an assessment of the visual performance in
relation to Dyslexia can begin. Routinely one of the first tests is for eye
dominance. We all have a dominant eye just as a dominant hand or foot. It does
not follow that if a person is right-handed he is also “right-eyed” We have
found in our practice that as many as 65% of the children referred to us with
suspected Dyslexia in fact display “cross dominance” where the preferred eye is
not the same as the preferred hand leading to a crossover in hand-eye
co-ordination. This simple observation seems to be a major factor in Dyslexia
and may be addressed clinically in several ways to assist development.
Colour tests are
undertaken, firstly to check if colour perception is normal. As many as 1 in 10
males are colour defective (Colour Blind) usually confusing dull greens, browns
and reds. Girls are very rarely colour
defective themselves although they carry the colour- defect gene from one
generation to the next. It is not possible to treat colour defects but there
are ways of helping sufferers to cope with the disability.
Specific perception
tests are then undertaken using a variety of methods. Reading ability is tested
using Overlays – these are special sheets of Acetate (plastic film) in
different colours which are placed over text of varying difficulty to determine
the most comfortable background colouring. The effect in a Dyslexic is often
quite dramatic, many report that words which have previously “danced” on the
page appear with the overlay to be quite stable and easy to read. In our
practice we have had the most success with the blue/grey Overlay at varying
density.
The Overlays have just
been introduced into a computer programme as a background for Visual Display
Screen text and we shall be shortly assessing this development as many of our
young Dyslexic patients show particular aptitude for I.T.
Results from the
overlays can then progress to an assessment using the Colourimeter.
This instrument
basically is a lighting system which can be varied in a programmed way by
adjusting intensity, contrast and colour rather like your TV controls to
produce the most comfortable reading illumination medium. The latest instrument
– Optim-Eyes has just been introduced into our practice and we are awaiting the
results of this exciting new development with interest.
The information obtained
from Overlays and Optim-Eyes can be used to produce what has perhaps been one
of the most useful accessories in helping Dyslexics – tinted reading glasses.
These are spectacles, usually with a very low power prescription lens which are
tinted to the shade and degree determined by the tests outlined above and
usually worn solely for reading, writing, number work, music and computer
visual display.
Children and young
people in full-time education are entitled to a NHS Voucher to cover all or
part of the cost of prescription spectacles although the cost of a tint to help
reading in dyslexia must be paid extra. The fees for tests relating to assessment of dyslexia over and above the
standard free NHS Eye Examination and also the provision of clinical reports
may vary from one practice to another and it is advisable to obtain some idea
of the costs involved prior to assessment in each case. Clinical reports of
Visual Function have been helpful to parents of Dyslexic Children who have
applied for LEA Statement for individual funding.
In addition to providing
tinted reading spectacles other advice may be given, for example the use of a
typoscope, in its simplest form an opaque ruler placed on the page to de-lineate
each line of print. Each patient who has been provided with advice and
treatment in the form of tinted reading spectacles will be closely monitored
with repeat appointments at regular intervals to reassess progress and to
liaise with parents and other professionals involved.
It is therefore clear
that Eyecare plays a very important part in the management of Dyslexia and
related learning problems although perhaps not in the way that sight testing
has been traditionally perceived. The role of the modern Optical Practice has
changed in many ways and this is surely one of the areas where
multi-disciplinary approaches have brought unusual advances in care and
treatment.
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