eye chartThis is the second in a two-part guest post by Dr. William O. Young. To read the first part, click here.

3. ChromaGen lenses

This is another twist on the tinted lens/overlay theme, though ChromaGen stresses that their lenses, which are various shades of gray and which may be different shades for the two eyes, are not the same as Irlen lenses/filters. ChromaGen lenses were developed 25 years ago as an attempt to treat colorblindness. More recently interest has developed in their use with struggling readers, and as was the case with Irlen lenses, the media have helped spread the word, including a very favorable (and uncritical) piece on ABC News: “Color-Filtering Lenses: Better Reading for Dyslexics?” November 30, 2011. (For a more objective review, see “The Healthy Skeptic: Promise of ChromaGen lenses for dyslexia a bit blurry,” in Los Angeles Times, November 28, 2011.)

Like the Irlen Institute, ChromaGen claims that their lenses help dyslexia by treating visual distortions, by altering the wavelength of light reaching the eye, and that about half of dyslexics could benefit from these tinted lenses (www.ireadbetternow.com).

Optometrists become ChromaGen certified providers by taking one hour (!) of online training and paying $1500 for a kit of lenses. After a $150 screening exam a pair of ChromaGen lenses costs the patient $750 to $1200; ChromaGen tinted contact lenses are somewhat less expensive.

No one other than the inventor of the lenses, who obviously has a financial interest in the outcome, has published a study supporting their effectiveness for reading disorders. Nevertheless, just as there are people who swear by VT and Irlen lenses, there are people who feel ChromaGen lenses have helped them, and who have provided glowing testimonials. It is these testimonials that have driven ChromaGen sales, despite lack of objective evidence that they work. The ABC story reports, “With such testimonials, ChromaGen’s Edwards downplayed the need for scientific studies to establish the lenses’ effectiveness.” Enough said. Placebo effect is a powerful thing.

4. Low-plus reading glasses

These are very weak reading glasses prescribed by optometrists for struggling readers on the basis that focusing on reading material, at reading distance, causes “near point stress” which is relieved by the reading glasses, thus allowing the child to read better. This concept of near point stress has been a part of optometric training since the 1920s, again without valid objective evidence.

There’s no way to explain why this therapy is bogus without some numbers. When we focus on things “at near” we have to accommodate, meaning crank in focusing power, to make things up close clear. (When we turn 40 we can no longer accommodate enough to see clearly at reading distance, so we need reading glasses.) Glasses prescriptions and accommodation are both measured in units called diopters. Assuming we are not farsighted, we don’t have to accommodate at all to see things very far away, but to see things up close (at book-reading distance) we have to accommodate about 3 diopters. If a child is, say, 1 diopter farsighted to begin with, she has to accommodate 3 + 1 = 4 diopters at near. But a child at, say, age 10 is able to accommodate about 14 diopters, and can sustain half of that accommodation (about 7 diopters). This means that this child is not even breaking a sweat to accommodate the 4 diopters needed to see at near: she has 14 – 4 = 10 diopters in reserve that she’s not even using!

And how much help do these low-plus readers provide? 0.5 diopters, typically (though I’ve seen them even weaker)! So the farsighted child reading with 0.5 diopter readers only has to accommodate 3.5 diopters at near, instead of the 4 diopters she requires without the readers—meaning that with readers she has 10.5 diopters in reserve, instead of the 10 she has in reserve without the readers. This is a truly insignificant difference, and again, any “effect” is placebo effect.

(Note, by the way, that these children who supposedly can’t read because of near point stress are able to play video games—without their “reading glasses”—for long periods at a time without difficulty…)

5. Omega 3 fatty acids

Omega 3 fatty acids are advocated by John Stein, one of the major proponents of the “magnocellular theory,” for treating reading problems (along with yellow and blue lenses). The magnocellular theory proposes that a certain type of cell in the retina of the eye fails to suppress the image of the letters you’re looking at now when you shift fixation to the next set of letters as you read, so that a “visual trace” of the last group interferes with the group of letters you’re trying to read now. A magnocellular deficit is believed by some proponents of Irlen lenses and ChromaGen lenses to be the reason for their lenses’ “effectiveness.”

The evidence for the magnocellular theory is debatable at best; my best interpretation of the current evidence is that even if some people do have a magnocellular deficit—a big “if”—it is unrelated to any reading difficulty they may have. (See “Visual Search Deficits are Independent of Magnocellular Deficits in Dyslexia” in Annals of Dyslexia.)

And as for the omega 3 fatty acids, the evidence for their effectiveness in dyslexia is….? (I’m not aware of any.) Look, omega 3 fatty acids are great: I take them myself because there’s evidence of cardiovascular benefit, and I recommend them to my patients with blocked oil glands in the eyelids (a common problem that causes red bumps in the eyelids called chalazia). They cause no harm that I’m aware of, they’re relatively inexpensive, and unlike the remedies discussed above, they may actually do some good (though not specifically for dyslexia). So if I had to pick one dyslexia “remedy” from this list of five, I’d pick omega 3 fatty acids, hands down!

Here’s the bottom line.

It seem very reasonable and logical to think that the eyes cause or contribute to dyslexia. It’s reasonable, logical, and almost always wrong! Dyslexia is a language processing problem, not a vision problem, and the valid remedy for dyslexia is targeted language therapy with daily practice, not eye exercises, tinted lenses, or reading glasses. There is simply no valid vision-based shortcut to treating dyslexia.

We are all, myself included, susceptible to being persuaded by anecdotal evidence: our friend down the street says something helped their child, so (we think) maybe it’ll help ours! As a parent, you are motivated by your desperate desire to help your struggling child, whatever it costs.

I urge you to hold out for objective evidence from an impartial source, and instead put your money toward valid language-based therapy that will actually help your struggling reader. Unfortunately, there simply is no quick fix for dyslexia.

For a comprehensive overview of the subject of the role of the eyes in reading and learning disorders, please see Learning Disabilities, Dyslexia, and Vision: a joint policy statement by the American Academy of Pediatrics, the American Academy of Ophthalmology, and the American Association for Pediatric Ophthalmology and Strabismus. It’s 32 pages and will take you a while, but is well worth the time.

For another objective review of controversial vision-oriented therapies for dyslexia, see the excellent article in the Winter 2011 edition of the International Dyslexia Association’s publication Perspectives on Language, entitled Vision Efficiency Interventions and Reading Disability,” by a well known dyslexia researcher and a pediatric optometrist.

—–

You can see an earlier Live Broadcast by Dr. William O. Young, The Role of the Eyes in Reading Disorders: What Parents, Teachers, and Therapists Need to Know.

Dr. Young has no financial interest in any dyslexia evaluation or remediation program, method or company, including Lexercise.

If you have questions or need a referral to a qualified clinician, contact me at AskSandie@Lexercise.com or 1-888-603-1788.

avatar

About the Author

Sandie Barrie Blackley, MA/CCC

Sandie is a speech-language pathologist with more than 30 years of experience in the private practice sector. She is Visiting Assistant Professor of Communication Sciences & Disorders at University of North Carolina Greensboro, and founder/owner of the Language & Learning Clinic, PLLC, a private practice in Elkin, NC, and Greensboro, NC, specializing in communication disorders, including disorders of reading and written language.
  1. avatar Angel says:

    Thank you do very much for sharing this! Could you please let me know if you have ever heart about Pavlidi’s method of accessing dyslexia observing eye movements?(it is a biological assessment) is this possible to observe
    Eye movements to assess dyslexia???? There is a lot of controversy about it in Greece where it is practiced. Thank you so very much for your time, kind regards angel

  2. Angel,
    Yes, this line of research (comparing the eye movements of dyslexics with the eye movements of normal readers) goes back to the 1980s. This a methodology is evolving but it not useful for diagnosis—at least not at this time.

    Here is a link to a recent article about eye movement research in dyslexia: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875174/

    Like everything else about dyslexia, it is pretty complicated. But one of the great things about dyslexia treatment in a computer age is that we can incorporate research in to treatment procedures quickly when research has reached a consensus. As this article points out, that’s not the yet the case with eye movement research.

    As we do with all the research pertaining to dyslexia and dysgraphia, we will keep an eye on this research (pun intended!). Our goal is to provide our clients with the most updated, research-backed and effective therapy available!

    Sandie

  3. avatar Liora says:

    hi, I’ve just been looking into Dyslexia and found TONS of evidence for Omega 3′s (PUFA’s) helping the condition including this overview of many clinical trials. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257637/

    plus these
    69. Baker S.M. A biochemical approach to the problem of dyslexia. J. Learn Disabil. 1985;18:581–584. [PubMed]
    70. Richardson A.J., Cox I.J., Sargentoni J., Puri B.K. Abnormal cerebral phospholipid metabolism in dyslexia indicated by phosphorus-31 magnetic resonance spectroscopy. NMR in Biomed. 1997;10:309–314. [PubMed]
    71. Richardson A.J., Ross M.A. Fatty acid metabolism in neurodevelopmental disorder: a new perspective on associations between attention-deficit/hyperactivity disorder, dyslexia, dyspraxia and the autistic spectrum. Prostaglandin Leukot. Essent. Fatty Acids. 2000;63:1–9. doi: 10.1054/plef.2000.0184. [PubMed] [Cross Ref]
    72. Stordy B.J. Dark adaptation, motor skills, docosahexaenoic acid, and dyslexia. Am. J. Clin. Nutr. 2000;71:323–326. [PubMed]
    73. Taylor K.E., Higgins C.J., Calvin C.M., Hall J.A., Easton T., McDaid A.M., Richardson A.J. Dyslexia in adults is associated with clinical signs of fatty acid deficiency. Prostaglandins Leukot. Essent. Fatty Acids. 2000;63:75–78. [PubMed]
    74. Taylor K.E., Richardson A.J. Visual function, fatty acids and dyslexia. Prostaglandins Leukot. Essent. Fatty Acids. 2000;63:89–93. [PubMed]

    and this one
    http://www.ncbi.nlm.nih.gov/pubmed/18158838

    combining DHA and EPA’s at a sufficient dosage, with Phosphatidyl choline even better
    http://www.ncbi.nlm.nih.gov/pubmed/18072818

  4. Thanks for your message. There certainly is a growing body of research that supports the importance to learning of all sorts of life style choices, including diet, exercise, rest, challenging tasks and mindfulness. Navigating the blizzard of research findings available today requires more than just critical thinking. It requires some educational technology!

    To help put all these “important” choices in perspective take a look at John Hattie’s Visual Learning. I had the pleasure of working on a project with Dr. Hattie some years ago, and I have followed his work since then. In his highly acclaimed analysis, Hattie has combined over 800 meta-analyses and more than 50,000 smaller studies, including more than 80 million students, and evaluated (and ranked) various educational choices using the powerful statistic of effect size. Hattie begins with the observation that, in education, ‘‘everything seems to work’’. (Interestingly, one of the very few educational choices that actually has a negative effect is one of the most commonly used in public schools in the USA: grade retention!)

    But, it’s important to bear in mind that most of these educational choices are not mutually exclusive. For example, you can both limit the hours of watching T.V. and assure your child gets adequate sleep. You can choose to provide both a healthy diet, rich in Omega 3s, AND structured literacy intervention. While it is unlikely that limiting T.V., adequate sleep and/or Omega 3s will, by themselves, improve a child’s reading and spelling, it is certainly possible that such life style choices will better equip a child to take advantage of research-backed learning opportunities like Lexercise structured literacy. Perhaps some of these choices even produce cumulative gains. Certainly, thought, there ARE some choices with much larger effect sizes than others. It would seem important to pay particular attention to those choices. One of the educational choices with the highest effect size is direct instruction. Another is structured, daily practice. And explicit teaching. Still another is parent education. We have built the Lexercise with a careful eye to these most powerful teaching and learning elements.

    As we work with families we definitely see the impact of life style choices like diet, exercise, rest, support for engaging in challenging tasks and mindfulness.

Leave a Reply

Concerned your child may be at risk of dyslexia? Take our free screener now! Get Started