Subtle Vision Issues Can Cause Big Problems

By Jane-Emily

A preliminary note: Although the cause of my daughter’s vision issue is quite rare, the problems we had because of it are pretty common and the therapy we used is helpful for a wide range of issues.  I hope that some people looking for ways to help their kids will find this useful.

My younger daughter’s 3rd grade year was something of a nightmare.  I didn’t know what to do with her.  She couldn’t explain the problem, and it took me a long time to connect the dots; I didn’t realize that the different issues we were having were all caused by the same thing.

Problem #1: She could read perfectly well, but she didn’t like to read.  I know not everyone is going to love reading as much as I do, but I found her avoidance of reading to be a little odd.  In particular, she would not try new books; she had to be completely convinced that she was going to love the story.  I would tantalize her by reading aloud whatever book I thought she would like–that usually worked, but quite often she would read some of a book and then leave it unfinished.  She much preferred listening, and I gave her lots of audiobooks.

Problem #2: Math.  I was mystified.  This kid started off enjoying math, and she had clearly inherited some of her dad’s skill at it.  Even as a toddler, she loved puzzles and blocks, and she grew into a confirmed Lego addict.  During math lessons, she learned well and enjoyed it.  But in 3rd grade, she started having inexplicable meltdowns.  She “hated math.”  We were using Saxon, and she did fine with the lesson part. She loved anything having to do with manipulatives, she understood the concepts, and she knew her math facts cold–but she balked at the problem sets, and the sheets of math facts (the ones with 100 to a page) sent her into an instant tailspin.

She complained of headaches.  She tried to weasel out of the work.  She cried.   But why?  She was perfectly capable.  When I was in 3rd grade we did those math fact sheets daily and I thought they were fun.  I wasn’t asking her to do anything unusual or difficult.

I tried all kinds of things.  We did “trampoline math” for the fact sheets, where I would call out the problems and she would answer them while jumping on a mini-tramp.  I would bribe her with an M&M for every row she finished.  We did a lot orally.  Still she balked and developed sudden headaches, but I didn’t really believe in them.  Since when do healthy kids get headaches at the drop of a hat?  I thought her headaches were fictional, a way to get out of doing what she didn’t want to do.  (This is where I win the Bad Mom of the Year Award.)

She started complaining about headaches more, even when she was doing things she liked to do–even when she was playing.  I took this development more seriously and started wondering if she had a real problem that we weren’t understanding.  My first thought was to take her to the eye doctor.

I should explain why I jumped so easily to the eye doctor idea:  I am horribly near-sighted, and my entire family is prone to having interesting eye problems.  This child invented a new one for us to deal with; she has a particular condition called Duane’s Syndrome.  One of her eyes does not have its full range of motion because the nerves that control the muscles on one side simply never developed.  There is nothing to be done about this, but our regular eye doctor and our friend the ophthalmologist (who explained it to me when she was a baby) didn’t seem to think it was any big deal, and she had never shown any signs of trouble.  I’d been taking her to get her eyes checked since she was 1 year old, and she had just gotten a checkup and a fresh pair of glasses before 3rd grade.  She had even lost the wonky astigmatism she’d had in that eye, so I thought things were going well.

It had only been maybe 6 months since she had last seen the eye doctor, but this time we were looking for a specific problem and he did some different tests.  She did not have good binocularity!  Her eyes were not working together as well as they should, even on her good side.  (Of course they can’t work together at all on her weak side–she sees double there.)  The doctor recommended vision therapy; he was certified in VT and would give us exercises to do.

This all came as something of a shock to me.  I’d gotten so used to her wonky eye that I hadn’t considered all the ramifications of it for her.  I called up our friend the ophthalmologist and asked his opinion.  He (and the pediatric ophthalmologist he referred me to) thought that vision therapy would be a useless waste of time and money.  I’m afraid I broke into tears on the phone and distressed him terribly, poor guy.

We were on a tight budget and vision therapy wasn’t covered by our insurance.  The idea of spending hundreds of dollars on something that might not work was hugely daunting to me, but how could I not try?  Besides, no other option presented itself.  It was VT or nothing.

So we gave it a try.  The doctor gave us simple exercises to do, often with items we had at home, though he also lent us equipment.  Every day, we did a set of exercises, and I learned much more about how her eyes work.   Our goal was to get her eyes working together as much as possible, given her incurable condition.

I’m happy and relieved to report that the exercises worked beautifully.  Over a few months, her complaints about headaches diminished and then ceased.  She became willing to read!  It still isn’t her very favorite thing to do (that would be Legos), but she enjoys books and, to my joy, spent the summer working through the entire “Warriors” series.  It helps if I search out editions with clear type that isn’t too small.  Her distaste for new, unknown books had been because reading was such hard work for her that she had to be convinced that it would be worth it–but of course she couldn’t articulate that.  A child who has never known otherwise cannot explain what is going wrong.

We developed a whole new set of habits for math:  I bought paper that allowed for larger writing, I discovered apps that presented practice problems in a beautifully large font, and we still did quite a bit orally.  Much of 4th grade was spent just getting her over the hatred of math she had developed–not because she couldn’t do the work, but because she couldn’t focus on the small print and it made her eyes hurt.

I’m grateful that we homeschool; I’m convinced that the amount of time I could spend observing her trying to work is what helped us to figure out the problem.   I had a thorough knowledge of her–her personality, talents, and issues from the day she was born–and it still took me months to figure it out.  I’m also grateful that I chose Saxon Math; with its plain layout and lack of fancy embellishments all over the page, it is actually the best text for her, since there is so little to confuse or distract the eye.   We did give up those 100-fact sheets, though.  They have tiny print that is just plain hard to see.

Considering the results, I think the hundreds of dollars we had to spend for VT was well worth it.  I imagine what her life would be like if schoolwork and reading were always a difficult struggle that caused pain.  It would be completely natural to hate school, and math, and reading!  At the time, I worried constantly about the money, because I wasn’t sure that the therapy would work.  Now, I think it one of the best things I ever spent money on.

My daughter’s particular eye condition is a rare one, but the problem that it caused is not.  I am no expert, but as far as I can tell, problems with binocularity are fairly common.  It’s hard to spot, though, because it’s so subtle, and the resulting behavioral problems look like a childish reluctance to cooperate.  Many people faced with a recalcitrant child don’t think of possible hard-to-detect vision issues.  So I am sharing my story here in hopes that if you have a child who hates math or reading for no discernible reason, a visit to an eye doctor who knows something about vision therapy will be on your list of things to do.  Vision therapy seems to still be not very well-known, and it could solve so many children’s problems!

Jane-Emily homeschools two daughters in California.  She is a librarian who loves to quilt and embroider, and she’s a Bollywood addict.  Her favorite author is Diana Wynne Jones. She blogs about reading at Howling Frog Books.