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Bright Eyes Family Vision Care in New Tampa FL
Bright Eyes Kids in Westchase Fl

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“Foolproof” Eye Test for ADHD

We have known for years that there is a link between how the eyes work and attention. This is why there are so many children who have both Attention Deficit Hyperactivity Disorder (ADHD) and visual coordination problems. Pediatric optometrists see this in the exam room every day and it is our job to help sort out how much of a child’s difficulty is due to ADHD and how much is due to not being able to visual focus and move their eyes efficiently.

There is some new research about ADHD and eye movements that is very compelling. Researchers in Tel Aviv, Israel, led by Moshe Fried, MD, have found that by simply monitoring involuntary eye movements, ADHD can be diagnosed.

“This test is affordable and accessible, rendering it a practical and foolproof tool for medical professionals,” said Dr. Fried. “With other tests, you can slip up, make ‘mistakes’ — intentionally or not. But our test cannot be fooled. Eye movements tracked in this test are involuntary, so they constitute a sound physiological marker of ADHD.

The study also showed that Ritalin (methylphenidate) does work in improving ADHD as measured by eye movement control. What was not researched in this study is how much other treatments that also improve eye movement control influence ADHD. Optometric vision therapy is commonly used to help patients improve their voluntary and involuntary eye movements.

Clearly more research is needed to better understand the relationship between ADHD and eye control, but this new study is a step in the right direction.



Measuring Eye Movements While Reading with the Visagraph III

Often parents will bring their children in for a comprehensive eye exam because they are concerned about the reading development of their child. They rightfully want to know if a visual problem is interfering with development of proper reading.

When evaluating an adult or child who has concerns about reading ability, there are several visual skills that I evaluate. These including clarity of sight, eye teaming, eye focusing, and eye movements. I have several ways to evaluate eye movements. Some of these tests rely on observation of eye movements; some tests involve timing the accuracy of read material.

I now have an additional method that I am very excited about. The Visagraph III™ is a computer-based system for measuring eye movements while reading. Through the use of infrared sensors, an individual’s eye movements are recorded while he or she silently reads an appropriate text selection while wearing special goggles. Following the reading, a brief series of questions determines whether or not the subject reads with reasonable comprehension. It can be used to confirm that a patient is a slower reader due to visual problems.

In addition to analysis of specific types of eye movements, I look at the overall path the the eyes take when the patient reads.

For example, a good reader will have a nice, even “stair-step” pattern from left to right with a smooth return to the left that is symmetrical for the right and left eye. The image below is from a real patient who reads well above grade-level:


But a person who has poor eye movement skills when reading will show lots of uneven movements both left and right as they go back to re-read certain words. They will also have irregular movements when the eye movements are not symmetrical. This could occur due to eyestrain, focus problems, or problems using the eyes as a team. The image below is from a patient that reads well below grade-level.poorreader

This test is important to perform both during the initial evaluation and again at the end of therapy, if any has been provided. That way, I have a comparison to determine the level of progress that has been achieved and how much this mirrors the improvement that patients and parents report in reading skill.

If you or your child appears to have reading skill that is well below what you think it should be, a complete visual evaluation is in order. There may not be a vision issue impacting reading performance, but if there is, it should be corrected as early as possible.

Be Well!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase and New Tampa neighborhoods.



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