OBJECTIVES: To explore associations between specific learning disorder with impairment in reading (dyslexia) and ophthalmic abnormalities in children aged 7 to 9 years.METHODS: Cross-sectional analysis was performed on cohort study data from the Avon Longitudinal Study of Parents and Children. Reading impairment was defined according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Children who achieved .2 SD below the mean in the Neale Analysis of Reading Ability Scale II and level ,4 in nonmathematical national key stage 2 tests were defined as having severe reading impairment (SRI). Children with blindness or IQ ,70 were excluded.RESULTS: Data were available for 5822 children, of whom 172 (3%) met the criteria for SRI. No association was found between SRI and strabismus, motor fusion, sensory fusion at a distance, refractive error, amblyopia, convergence, accommodation, or contrast sensitivity. Abnormalities in sensory fusion at near were mildly higher in children with SRI compared with their peers (1 in 6 vs 1 in 10, P = .08), as were children with stereoacuity worse than 60 seconds/arc (1 in 6 vs 1 in 10, P = .001).CONCLUSIONS: Four of every 5 children with SRI had normal ophthalmic function in each test used. A small minority of children displayed minor anomalies in stereoacuity or fusion of near targets. The slight excess of these children among those with SRI may be a result of their reading impairment or may be unrelated. We found no evidence that vision-based treatments would be useful to help children with SRI.WHAT'S KNOWN ON THIS SUBJECT: Dyslexia has a lifelong impact on learning. The consensus in the literature from clinical studies is that dyslexia is not caused by vision abnormalities. However, interventions and therapies directed at eye-related functions are still available.
WHAT THIS STUDY ADDS:In this cohort the majority of dyslexic children had normal results for all ophthalmic tests. These population-based data support the consensus that dyslexia is not primarily a vision problem and that vision-based therapies are not justified or likely to help. Dr Creavin planned the study questions, analyzed the data, interpreted the results, and wrote the manuscript; Dr Lingam planned the study questions and the original clinical assessment of the Avon Longitudinal Study of Parents and Children (ALSPAC) children along with the rest of the ALSPAC team and was involved in interpreting the results and writing the final manuscript; Dr Steer was involved in interpreting the results and writing the final manuscript; and Dr Williams planned the study questions and the original clinical assessment of the ALSPAC children along with the rest of the ALSPAC team and was involved in interpreting the results and writing the final manuscript. A number of neurodevelopmental conditions are associated with ophthalmic abnormalities. 7-9 Reading requires adequate vision and the neurologic ability to identify what is seen, and consequently the study of difficulties in vision and vis...