Could Vision Problems Cause an Attention Deficit Disorder Diagnosis?
There are two points that will help here:
1. Attention deficit disorder is a diagnosis of exclusion. There is no specific test for it, as it is simply a collection of behavioural symptoms. As a diagnosis of exclusion, all other causes for the behaviour must be ruled out.
2. Behaviour is almost always secondary.
Imagine yourself riding a bicycle with a group of other people of similar fitness. Now if the tires on your bicycle were flat and the wheels were bent, how long do you think you would like to ride for in comparison to the other people? Do you have to put more energy in than the other riders just to get the same return? Do you think you would be able to ride for as long as the others? How frustrated might you become? Would you like to ride your bike?
Is it your behaviour or the bicycle?
Your behavior will likely show that you tire out easily, that you may avoid biking, or that you dislike it. Is your behaviour the problem, or is it simply the product of an underlying issue with your bicycle? This is remarkably similar to a person’s visual system. If the coordination of the eyes, and the processing of the visual input are very inefficient, it will make it more difficult for the person to maintain focus, or to stay on task.
The bicycle can be seen
With a bicycle we can clearly see and understand what is causing the problems. No parent would be yelling at their child to try harder if they could clearly see what was wrong. No parent would think of letting their child struggle with self esteem issues because they couldn’t keep up to the other riders. More importantly, nobody would diagnose the child with a disorder or syndrome based on their poor cycling abilities.
Visual problems causing attention problems
So if it’s been established that:
- Visual problems can cause the same symptoms as used to diagnose attention deficit disorder
- Attention deficit disorder diagnosis requires the exclusion of ‘developmental sensory problems’ (see DSM-V)
Then it should follow that the standard of care should be to have all visual skills tested before considering an attention deficit mis-diagnosis. In the cases where it is an underlying visual disorder, this will prevent mis-diagnosis, prevent mis-medication of children and adults, and allow them to reach their full potential.
The examination should cover tracking abilities, visual processing, and an in depth look at how the eyes coordinate together.
Read more about what an examination should cover here.
Please visit the education area to read more about vision and attention here.
Read about a young patient who may have been diagnosed with attention deficit disorder if his visual problems hadn’t been uncovered here.
Yours in vision, Dr. Cam