Ophthalmic factors in dyslexia

Although the role of ophthalmic factors in dyslexia remains the subject of controversy, recent research has indicated that the correlates of dyslexia may include binocular dysfunction, unstable motor ocular dominance, a deficit of the transient visual subsystem, and an anomaly that can be treated with tinted lenses. These features, typically, have been studied in isolation and their inter-relationship has received little attention. The aim of the present research was to investigate ophthalmic factors in dyslexia, with a particular emphasis on the interaction between optometric variables. Further aims were to establish the most appropriate investigative techniques for optometric practice and to explore the relationship between optometric and psychometric variables. A pilot study was used to refine the experimental design for a subsequent detailed study of 39 children with a specific reading disability and 43 good readers, who were selected from 240 children. The groups were matched for age, sex, and performance IQ. The following factors emerged as correlates of dyslexia: slight impaired visual acuity; reduced vergence amplitudes; increased vergence instability; decreased accommodative amplitude; poor peformance at tests that were designed to assess the function of the transient visual system; and slightly slower performance at a non-verbal simulated reading visual search task. The `transient system deficit', as measured by reduced flicker sensitivity, was significantly associated with decreased accommodative and vergence amplitudes. This links the motor and sensory visual correlates of dyslexia. Although the binocular dysfunction was correlated with increased symptoms, the difference in the groups' simulated reading visual search task performance was largely attributable to psychometric variables. The results suggest tht optometric problems may be a contributory factor in dyslexia, but are unlikely to play a key causative role. Several optometric variables were confounded by psychometric parameters, and this interaction should be a priority for future investigation.