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Vision and Learning History

A Little History Lesson About
Vision and Learning

by Lisa Nisula

In 1862 a man named Snellen developed a method for determining the accuracy of people's eyesight.  He asked people to stand 20 feet away.  Through experimentation, he found that the smallest letters that most people could comfortably see were what he called “size 20 letter”. Thus “perfect vision” was called 20/20- size 20 letter at 20 feet away.  This was quite a breakthrough at that time. Now 150 years later, even with huge changes in medical technology, this test is still the standard that vision is tested by.
Eye Test
Vision is the learning system that generally provides that most for the processing of information and how most learning is presented.  Studies have found that up to 80% of all learning in school, and the information about the world around us, is received visually.

The ways that we learn are visual, auditory a kinesthetic (hands on).  Lesson plans usually are based on “see it, say it and do it,” so that all 3 modes were incorporated to better help the student integrate the information and make it “their own”.    

Children are not born with the skills that they need to see well.  Like many other skills, such as walking or talking, these skills need to be learned. We all need to learn how to SEE and correctly process visual input. Yet often when vision problems are suspected only acuity of distance vision is tested.  

By only testing acuity, the ability to see at a distance may test “normal” leaving the patient to believe that everything is fine and that the problems they may be encountering  are not eye-related. This plus the fact that vision related symptoms can present themselves in non-vision related ways can make diagnosing visual issues very difficult.  

Some symptoms of vision and learning issues are blurred vision and double vision.  Often children don't complain about these because they often don't realize anything is wrong.  They have nothing to compare to and think this is how everyone sees.  Additional symptoms include headaches, tired or strained eyes, blinking or rubbing eyes.  These symptoms may bring a patient to a doctor for evaluation, but other symptoms can be more troubling and can be overlooked.  Such as:

  • taking longer to finish work
  • avoidance or dislike of reading
  • skipping words
  • losing their place
  • omitting or repeating words
  • short attention span with visual tasks
  • frustration and acting out
  • not comprehending material since they are working so hard just to 'see” they miss the story details
  • behavior issues because they can't keep up
  • reversal of letters
  • poor handwriting and difficulty identifying or reproducing letters or shapes that are shown
  • not finishing board work or mistakes in copying information

These symptoms can seem like the child is, lazy, forgetful, not focusing, misbehaving, not paying attention or simply not trying hard enough especially when they have been tested and have “perfect or near perfect vision” using the Snellen standard vision test.

Learning-related vision problems are not learning disabilities, but many learning disabilities can be directly related to vision issues or at least complicated by them.  Vision problems can also lead to low self-esteem and depression.

Vision is very complex, it involves so much more than just acuity.  It involves the eyes, but also the brain, and the way that images are perceived and integrated.

The areas that must be looked at and tested are:

1.    Eye health and refractive problems, these are the acuity tests that we are most familiar with. These can often be corrected with eyeglasses, contact lenses or eye surgery.
2.    Functional vision problems such as eye teaming, (the eyes working together), accommodation (focusing amplitude, accuracy and flexibility -shifting from distance to near and back again) and convergence, which is the  ability of the two eyes to stay accurately and comfortably aligned.
3.    Perceptual vision problems occur when you have difficulty understanding what you see, judging its importance, identifying it, and relating it to other stored information, or using your eyes and brain to form a mental picture of the words or image that you are seeing.

As we know with most routine eye exams only the first category of these vision problems are evaluated, a “functional and perceptual evaluation” must be done to diagnosis the other issues.

Studies have shown that once learning-related vision problems have been diagnosed and treated, the patient will perform much more effectively and successfully in the classroom and even in the outside world.

In conclusion, it is important when anyone is seen to be struggling with something that should not be a task outside their developmental realm that all avenues need to be researched. Vision is such a fundamental part of our everyday life and everyday vision and learning experience making sure that our eyes are working as they should is essential.  If you were limping or unable to hear you would do what is needed to correct the issue.  Why would eyes be anything less?  If anything, they are even more important since they are the windows “to our soul” and all that we comprehend and perceive.

I am amazed each day as I watch and work with our patients to see what problems they come to us with and how the activities that are prescribed help them in such a non-evasive and relatively short time.  I wonder and worry how often I have overlooked these vision and learning issues or attributed them to something else.

Please note:  In-office therapy under the direction of a behavioral optometrist using prisms, filters and lenses, as used with our patients, is far more effective than home-based therapy.

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