Tag Archives: accommodative dysfunction

accommodative dysfunction

Accommodative Dysfunction: An Often Overlooked Vision Problem That Makes Classroom Learning Difficult

The Visual Learning Center offers 
developmental optometry & vision therapy
near Silver Spring, MD in Olney.

Accommodative dysfunction is an often-overlooked functional vision problem that makes classroom learning difficult and interferes with performance in school. When parents contact us at the Visual Learning Center, they often wonder how their child could have a vision problem that interferes with learning when their family eye doctor or school vision screening did not detect anything wrong with the child’s eyesight.

We understand that, as a parent, you rely on professionals to diagnose problems and advise you on the best course of action to help your child. But the eye doctor who examined your child is probably not trained in developmental optometry, functional vision care, or vision therapy. Their job is primarily to check for eye health and prescribe eyeglasses as needed.

The visual system is complex and routine vision screenings do not mimic the classroom environment. To do their assignments and follow lessons in a classroom setting, students must sustain visual focus over extended periods of time and shift focus from one place to another throughout the day.

If your child sees the board clearly and sees the paper on their desk clearly, they may pass a typical screening with 20/20 eyesight. But everyday classroom tasks require vision skills beyond a quick glance at an eye chart. In order to complete their schoolwork, a child has to maintain focus on their books or papers long enough to read paragraphs and pages of text. And while in the classroom, students have to focus on the board long enough to follow the lesson and look back and forth between the board and their paper to copy notes.

Weak accommodative facility refers to difficulty with visual focus. In normal healthy vision, a child can sustain visual focus for an extended period and shift focus as needed from near to far and back to near again. If our visual system is functioning as it should, we don’t even think about maintaining focus or focusing our eyes as we move them. Focusing happens automatically and almost instantaneously without much effort.

But what happens automatically for most of us takes strained effort in someone with accommodative dysfunction. The “focusing” (ciliary) muscle must expand and contract efficiently to change the shape or curvature of the lense as needed to see clearly. 

If your child is struggling with accommodative facility, the focus mechanism in their visual system is either not fully developed or has been weakened. While reading, their eyes may lose focus over time, causing the text to become blurry. If so, they will have to strain to regain focus again and again, leading to fatigue and frustration. While copying from the board or from a book to a page, the focus adjustment period is slower than normal, which is also frustrating.

Signs or symptoms of accommodative dysfunction include:

  • Complaining of blurred or fuzzy vision, especially towards the end of the day
  • Rubbing, squinting eyes, or closing eyes while reading
  • Missing more questions at the end of a test
  • Copying from the board slowly or with lots of mistakes
  • Poor attention span, fidgeting, and behaviors often mistaken for ADD/ADHD
  • Bending close or bobbing and tilting head while reading
  • Headaches or aching eyes
  • Avoiding reading or near work, especially with small print

Simple tasks that come easily to their classmates are challenging and tiring for students with accommodative dysfunction. They may work slowly and become discouraged with their pace and progress in comparison to their peers.   

If you suspect your child might have trouble with visual focusing, schedule a functional vision exam with an optometrist trained in developmental vision care right away. If diagnosed, vision therapy treatment can result in significant improvement in a relatively short period of time.

If your family is located in Olney or Silver Spring, Maryland, contact the Visual Learning Center today to schedule a functional vision exam with our developmental optometrist, Dr. Philip Nicholson.

Register for an upcoming webinar here.

problems copying from the board

Why Copying From The Board is So Difficult for Some Children

Does your child complain that copying from the board at school is difficult? Does he or she come home with partial notes with a lot of errors or missed assignments? Perhaps your child’s teacher regularly states that the instructions, due dates, or lessons were written clearly on the board, and your child claims to have missed important information.

As a parent or teacher, it may be hard to believe that a child is truly having difficulty copying from the board, particularly if that child has 20/20 eyesight, wears corrective lenses, or has been moved closer to the board for a clear line of sight. You may attribute the child’s behavior to carelessness, laziness, or an excuse.  However, certain functional vision problems that often go undiagnosed can make copying from the board extremely challenging for some students.

Vision disorders that interfere with a child’s ability to easily copy from the board at school include:

Poor eye teaming:

Binocular vision skills include the ability for two eyes to work together as a team. When a visual deficiency prevents both eyes from moving precisely in the same direction at the same time, reading and copying from the board can pose a problem.

If a child has an eye teaming disorder, he may be able to fixate on the vision chart in a typical eye exam and see it clearly, but moving his eyes together from one point to another is difficult. Moving the eyes together to look up at the board, down at the desk, and then back up without getting lost should be easy. But children with eye teaming problems will experience visual fatigue and tire quickly when attempting to copy from the board.

Accommodative dysfunction:

Weak accommodative facility refers to difficulty with visual focus. In a typical vision exam, a child may have clear 20/20 eyesight, but the exam usually does not require the child to sustain focus for an extended period of time or to shift focus quickly from far to near and back to far again.

The student may see the board clearly and see his paper clearly, but looking up and down, back and forth, from the board to the paper could be where the difficulty comes into play. If the focus mechanism in a child’s visual system is weak or not fully developed, the adjustment period as he looks from one point of sight to another will be slower than average, which can be challenging and frustrating.

Oculomotor deficiency:

If a student has deficient oculomotor skills, also known as an eye tracking problem, he will strain to accurately and efficiently control eye movements. Whereas in people with healthy visual systems, eyes move somewhat smoothly, in people with poor oculomotor skills, the eyes will jump or skip around the text.

Copying from the board is difficult for students with eye tracking problems because each time they look up at the board or back down at the paper, they have to struggle to point the eyes in the intended direction again. They tend to lose their place often and fall behind or make errors.

Visual processing problems:

If a student has a visual memory problem, a deficiency in the visual system interferes with retaining information that was just learned; so recalling a line of text just read from the board long enough to write on paper is difficult. If a student has a problem with visual sequential memory, he will have trouble remembering the proper sequence of words or letters in the order just seen. A child who struggles with visual spatial skills and visual discrimination skills may process letters or words they see backwards as they copy text from the board, so you may notice letter reversals and suspect dyslexia.

Children with learning-related vision disorders struggle now more than ever, because today’s classrooms often require students to spend hours each day interacting with boards and screens. In a typical school, you might find whiteboards, large projected screens, Promethean Boards, and ActivBoards. A child may spend a significant portion of the day straining to look at boards and then back down to the paper on the desk in front of them, and then back up to the board. If that student has a functional vision problem, copying from the board will interfere with learning the lesson or keeping up with classmates.

Trouble copying from the board can contribute to slow progress, low grades, and frustration. When a child is not able to learn and participate efficiently alongside his classmates, self-esteem or behavioral problems may arise.

Many teachers, learning specialists, occupational therapists, and other education professionals are not trained to detect functional vision problems. Most learning-related vision problems even go undetected during school vision screenings or exams with your family eye doctor.

Click here to learn more about learning-related vision problems.

If you suspect a vision problem could be to blame for your child’s problems copying from the board, find an optometrist in your area who specializes in developmental or functional vision care. If you live near Olney or Silver Spring, Maryland, schedule an appointment with Dr. Nicholson’s Visual Learning Center for a full visual analysis.

The good news is and intensive vision therapy program can significantly improve functional vision problems in a relatively short period of time. Within a few months, copying from the board could become much easier quickly.

child with accommodative dysfunction

Functional Vision Problems: What Happens if Your Child’s Eyes Do Not Focus Like They Should?

Sometimes we need to see things far away, and sometimes we need to see things that are nearby. From moment to moment, those needs change. A child at school, may need to see the worksheet on her desk, the equation the teacher is writing on the board, a book on her lap, a list on the bulletin board, a digital tablet, or a big screen video in the front of the classroom.

Eye muscles function one way to see close items clearly and they function a different way to see items clearly at a distance. The muscles that focus the lenses in our eyes have to adjust quickly and often to focus on various points of visual interest or sustain that focus over an extended period of time. Otherwise, our vision becomes fuzzy or blurred.

If a child has “normal” healthy vision, he or she will have the ability to bring objects of visual interest into sharp focus rapidly and sustain focus as needed. This function is automatic, subconscious, and occurs without extra concentrated effort or strain on the vision system.

However, children with poor focusing skills have a functional vision problem we refer to as accommodative dysfunction. A child with an accommodative disorder has to put forth extra effort and concentration to bring a blurry object into focus or to maintain focus for a sustained period of time. The child will struggle to bring the text on the page in front of her into focus, and then look up to see blurry text on the board, and struggle all over again to bring it into focus.

Her classmates without a focusing problem, will look up at the board and down again at their paper, seeing text clearly each time with no extra concerted effort.

Research has shown that elementary students spend as much as 75% of their day looking back and forth from near to far. So it comes as no surprise that a child who has trouble focusing will grow weary, stressed, and frustrated throughout the day. As a result, these children often lag behind in progress and performance, and sometimes they are misdiagnosed with learning disabilities, dyslexia, behavioral disorders, or attention problems.

Signs your child may have accommodative dysfunction include:

  • Missing more questions at the end of a test
  • Copying from the board slowly or with lots of mistakes
  • Complaining of blurred or fuzzy vision, especially towards the end of the day
  • Rubbing and squinting eyes
  • Poor attention span, fidgeting, and behaviors often mistaken for ADD/ADHD
  • Bending close or bobbing and tilting head while reading
  • Headaches or aching eyes
  • Avoiding reading or near work, especially with small print

A typical eye exam by your family eye doctor or school vision screening generally only tests clear vision at a distance. Most eye doctors do not test accommodative facility, so it’s possible to have 20/20 eyesight yet still have poor focusing skills.

If you suspect your child might have trouble focusing, schedule a functional vision exam with an optometrist trained in developmental vision care right away. If diagnosed, vision therapy treatment can result in significant improvement in a relatively short amount of time.

Click here to read Vision Therapy success stories.

If your family is located in Olney or Silver Spring, Maryland, contact the Visual Learning Center today to schedule a functional vision exam with our developmental optometrist, Dr. Philip Nicholson.