Children who have difficulty reading are sometimes referred to pediatric optometrists, often due to conditions like convergence insufficiency and problems with tracking. These terms are common throughout pediatric ophthalmology, but what do they mean, exactly?
"Convergence insufficiency is something that we do test for and we do treat," says Dr. Rose Hughes, a pediatric optometrist at University Children’s Eye Center. "Tracking is a little bit more problematic. The reason for that is that the eye movements associated with reading are not tracking in a smooth, linear fashion like you might think. The eye movements associated with reading are small jumps and the more proficient the reader, the bigger those jumps are and the more words that are incorporated."
So where does the problem begin?
"A more proficient reader will make fewer backwards jumps," Dr. Hughes continues. "A beginning reader or a reader who is having difficulties will make lots of little forward jumps and significantly more backwards jumps. So that can contribute to slower reading and losing your place when you read. What the studies have shown, however, is that to make the eye movements associated with reading more efficient, you don't do therapy to improve eye movements; you actually do therapy to improve reading. And by therapy I mean with a teacher, with a parent, with a reading specialist. It's not vision therapy. And what they found is that as the reader becomes a better reader, the eye movements will improve as well. It's not the other way around."
What does this mean in practice?
"When a child comes in for issues with learning," says Dr. Hughes, "we do a comprehensive eye exam where we check vision at a distance and near. We check for convergence insufficiency, which is difficulty pulling the eyes together up close. We make sure the eyes can move in all directions of gaze with no restrictions. We make sure there's no drifting or crossing of the eyes. We make sure that glasses are not needed. And we also check the health of the back of the eyes. If a convergence insufficiency is found, then we will do therapy for that."
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