Don’t mistake ADHD with vision problems – The Edwardsville Intelligencer

Dr. Julie Steinhauer, owner of Vision for Life and Success in Glen Carbon, displays the machine used to test visual field inattention span.
This is the visual field inattention span test at Dr. Julie Steinhauer’s office at Vision for Life and Success in Glen Carbon. The red circle inside the rectangle corresponds to the limited field of vision caused by visual field inattention span, which Steinhauer likens to seeing through a straw.
A sample of goggles with a variety of filters at Dr. Julie Steinhauer’s office at Vision for Life and Success in Glen Carbon. The goggles are used for light therapy, or syntonics, as part of a treatment program for vision conditions such as convergence insufficiency.
GLEN CARBON — October is ADHD Awareness Month, and a 2016 parent survey by the Centers for Disease Control and Prevention (CDC) shows that some 9.4% of children ages 2-17 have been diagnosed with ADHD.
But some symptoms of ADHD are similar to symptoms of vision problems. Dr. Julie Steinhauer, owner of Vision for Life and Success in Glen Carbon, says parents should have their children thoroughly tested for a vision condition before embarking on a regimen to treat ADHD.
Steinhauer noted that symptoms such as overactive behaviors, the inability to sit still, decreased focus on homework and short attention spans, may not only be attributed to ADHD but also a visual processing disorder.
“We see that about 90% of kids who are diagnosed with ADHD have a visual problem called convergence insufficiency or CI,” Steinhauer said. “That’s a condition in which they have difficulty aligning their eyes and crossing their eyes for reading.
“They may get double vision, or they may see things wiggle or move when they try to read. It causes them problems with trying to be attentive.”
Steinhauer’s testing process can determine whether a child has CI. There is no specific test for ADHD.
“The way that I make an easy delineation between the two things for parents is that if the child can’t sit still to watch a movie or a TV show or play a video game, they may truly have something like attention deficit hyperactivity disorder,” said Steinhauer, who is one of a select group of functional vision doctors in the nation.
“But if they can’t sit still for homework but they can play video games for four hours or watch a movie without trouble sitting still, that means they don’t have an attention span problem but have a problem with attention for the task they are doing. Even if they do have ADHD, it still doesn’t mean they don’t have a visual component that’s making things worse.”
If a child is diagnosed with a visual problem, Steinhauer has them start a program of vision therapy with two components.
The treatment process takes about 45 weeks, although patients can sometimes see improvement after three months.
The first component is light therapy or syntonics.
“The patients wear goggles with different colors that electrically reprogram the brain to function in a certain way,” Steinhauer said. “We can use them to retrain the brain to align the eyes if they have problems crossing their eyes, and we can use certain filters that help them focus better.
“The second component is more mechanical. We’ll do things like patching (their eyes) and have them track and focus with each eye individually. We teach them how to use their two eyes better together as a unit.”
In addition to the physical effects, Steinhauer noted that undiagnosed or untreated ADHD or vision problems can lead to psychological issues as well.
“A lot of times kids aren’t going to tell their parents that every time they try to read, the print moves and wiggles around,” Steinhauer said. “A lot of times they’re just thinking there is something wrong with them and they don’t want to mention it because they might get in trouble.
“If kids are not aware of their visual system at all, they may not even be able to tell you they see double. They may just say they don’t like to look at stuff up close because it doesn’t look right.”
Steinhauer added that one element which is consistent with ADHD is something called a visual field inattention span.
“Kids that have ADHD will often have a visual field opening that’s equivalent to looking through a straw, and that’s all their brain processes at any given time,” Steinhauer said.
“That will affect their reading skills and they move around a lot because they’re sampling their visual environment through that straw. They will be highly distractable and if there is a sound in the classroom, they’re going to turn to look for it. They can’t rely on their peripheral vision to see it.”
For children that have a visual field inattention span, it doesn’t mean their brain can’t see things. Rather, it makes it more difficult to process what they see around them.
“It’s almost like you have blinders on. It’s kind of like tunnel vision,” Steinhauer said. “If you tell them to look straight to see if there is a window over here, they might say they see something there, but they would move to see it better.”
In many cases, Steinhauer has found reducing or eliminating convergence insufficiency will help rid the behavioral issue altogether. This can include a therapy program, glasses or both.
If not, additional courses of treatment, both holistic and with medication, may be necessary. In any case, Steinhauer said a visual exam is a good first step to diagnose the issue and determine a proper course of treatment.
“If there is a convergence insufficiency, it is treatable and correctable from the sight and vision avenue,” Steinhauer said. “Most of the time when we treat those things, they may have been on medication for ADHD and a good portion of those kids can go off of that medication.
“If they truly have ADHD, they may need some medication for helping them in certain aspects, but the dosage can be decreased once the visual aspect is corrected because the vision component is so significant.”
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Scott Marion is a feature reporter for the Intelligencer. A longtime sportswriter, he has worked for the Intelligencer since December 2013. He is a graduate of Brentwood High School and the University of Missouri School of Journalism.