I have maintained for many years that I could walk into a classroom and pick out those children with coordination type visual problems. They get into distorted postures in an attempt to get one eye out of the act. They often put their head down on their arm, cover one eye with their palm or rotate their head so that the bridge of their nose interferes with the vision from one eye.

Another eye coordination problem is termed esophoria, which is a tendency for the eyes to turn inwards. The educational implication of this particular problem is that a child with esophoria sees things smaller than what they actually are. In order to see an object properly, it is necessary to make the object larger. The only means at the disposal of the child to make it larger is to bring it closer. Eventually, the child is observed to have his head buried in the book and still not achieving.

One of the tests used in optometric offices is to have the child read words while looking into an instrument called a Telebinocular. The performance is compared between reading with either eye alone as with both eyes together. The difference in performance is often quite dramatic if there is an eye teaming problem. One eye performance might be quite satisfactory, but reading with both eyes together will be slower and many More errors will be made.

Hyperactivity

There are many theories currently in vogue attempting to explain why some children are hyperkinetic. I am currently involved in a study involving the relationship between the alpha rhythm of the brain, the visually evoked response, visual attention and hyperactivity. The alpha rhythm which is generated in the occipital lobe measures between eight and twelve cycles per second. It has been discovered that children who can't suppress their alpha rhythm are children who can't pay visual attention and are hyperactive. Children who are accused of not paying attention actually are paying too much attention to everything else. The tick of the clock has just as much stimulus value as the teacher's voice. Every sound and every peripheral stimulus distracts this type of child. The alpha rhythm is thought to act like a radar system which is monitoring all of the other sense modalities and must be suppressed to pay sole attention to the central visual stimulus. The alpha rhythm measures approximately 50 microvolts whereas the visually evoked response measures approximately 15 microvolts. Consequently, there is a signal to noise relationship which makes it difficult to appreciate the visual stimulus. It has been found that through vision therapy, a child can be taught to point his eyes accurately and this results in his ability to suppress the alpha rhythm. This, in turn, results in better visual attention, loss of hyperactivity and increased academic performance.

There are many other theories of hyperactivity that most nutritionists are familiar with. Some children are especially sensitive to artificial food flavorings and colorings. There also are substances other than additives which can cause allergies which manifest themselves in hyperactivity, Higher than normal levels of lead have also been implicated in hyperactivity.

Megavitamin therapy has proven to be effective in many cases. Ritalin and amphetamines have been commonly used in the battle against hyperactivity. I feel that these drugs are very good for parents and for teachers, but not very good for children. The drugs treat only the symptoms and do not get at the cause of the problem.

Some children have difficulty in developing the proper figure-ground relationship in their visual system. They do not have the ability to make one object figure and the other objects background. All objects assume figure level and the child is constantly shifting fixation from one object to another. One of the goals of vision therapy is to build a visual space world so that a child can make one object figure and the others ground and then make a volitional movement to make another object figure and the rest ground.

Another contributing cause of hyperactivity may be artificial lighting. Television radiation has also been implicated. There are studies that show that when artificial lighting and television are removed from the child's environment, the hyperactivity is sometimes reduced or eliminated.

Other Visual Skills

Directionality is another visual skill important for academic success. One test for this skill is illustrated in Figure #5. Look at Figure #5 and determine what you see. If the visual reflex is from left to right, a duck will be seen. However, if the visual reflex is from right to left, a rabbit will be seen. This is just one test out of a series to determine the directionality of the visual reflex.

Figure 5

It is just a convention of our culture that the English language proceeds in- a left to right direction. Other languages proceed in a right to left direction and still others have a vertical orientation. Many people feel that it would make more sense if the language proceeded as illustrated in Figure #6. If a child does not visually proceed from left to right, through vision therapy he can be taught to develop this skill just like he can be taught to team his eyes together.

Figure 6

Form perception is another important visual skill for academic achievement. This can best be illustrated by referring to Figure #7. The child is shown these forms one at a time and he is simply asked to copy them. It is amazing to see some of the distortions that a child will make in attempting to copy these forms. If a child can't perceive and copy these simple geometric forms, it is unreasonable to assume that he will be able to perceive the wiggly lines which make up letters which in turn make up words, which in turn make up sentences which stand for abstract ideas. We see children often who can't tell the difference between a square and a rectangle or a circle and an oval. This is also a skill which can be improved through vision therapy.

Figure 7

The Span of Perception is also related to success in school. Many children see just one word at a time with each eye fixation. Reading speed can be improved by learning to see two, three, or more words with each eye fixation. This could be compared to reading through a straw. This is illustrated in Figure #8. It is easy to see the difference in reading for meaning when the span of perception is wide.

Figure 8

The ultimate visual skill is visualization. This is similar to being able to see things in the mind's eye. There are authorities that state that the ability to visualize is very closely allied to the ability to think. In other words, thinking is related to the ability to abstract from specifics and the ability to visualize is deeply involved in this process. Visualization is also a trainable skill.

There are many other visual skills that time and space do not permit me to mention. However, it is hoped that the reader will realize from the above discussion that there is a lot more to vision than just 20/20.

Conclusion

When I see a child with a learning problem, I feel very strongly that there usually is more than just a single cause. For example, when I find a visual problem, if I probe a bit further, a nutritional problem will be found as well. Children often walk into the office eating a candy bar or sipping on a cola or other soft drink. When they are asked what they had for breakfast, the response usually falls in the frosted, sugary flake category or the answer is that they had no breakfast at all.

When I am asked which nutrients are important for optimum visual functioning, I respond that the same nutrients essential for the rest of the body are the ones needed for vision. This is because that vision does not operate independently of the rest of the body.

In all cases, a diet of high quality, whole, natural foods is important if we are going to be successful in vision therapy. Vision therapy is a learning process and, as with any learning process, learning will be maximized if a healthy body and a healthy mind are brought to the learning task.

Bibliography

Feingold, Ben F.. M.D., Why Your Child Is Hyperactive, Random House, New York, 1975.

Getz, Donald J., O.D., "Vision and Perception Therapy," 1973. College of Optometrists in Vision Development, Post Office Box 285, Chula Vista. California 92012.

Lane, Benjamin. O.D., "Myopia," 1976. College of Optometrists in Vision Development

Ludlam, William, O.D., "Visual Evoked Response," 1974. College of Optometrists in Vision Development

McDonald, Lawrence W., O.D., "Visual Training," 1962-1963. Optometric Extension Program

Ott, John. Sc.D., Health and Light, The Effects of Natural and Artificial Light on Man and Other Living Things, Devin-Adair Co., 1973.

Skeffington, A.M.. O.D., Continuous writings, Optometric Extension Program

BIOGRAPHY

Donald Getz, O.D. Specializing in strabismus and amblyopia and visually related learning problems, Dr. Getz is past President of the College of Optometrists in Vision Development. He has consulted to the Los Angeles School System reading improvement program, lectures often to vision training seminars on children's vision and visual problems. As chief consultant on strabismus and amblyopia to the California Oplometric Association, he has lectured and conducted seminars throughout the United States. Dr. Getz was graduated magna cum laude from Los Angeles College of Optometry, is a member of numerous professional organizations, and has authored various scientific papers.

Reprinted with permission from The Journal of Applied Nutrition Volume 28, Winter, 1976.