Convergence Insufficiency (CI) versus ADHD

Did you know there is an eye disorder that can be mistaken for ADHD?  You cannot medicate against the eye disorder, it is frequently missed, or misdiagnosed as ADHD!  No matter how many meds you put your child on, it will not help.  Convergence Insufficiency (CI) affects the way eyes track together.  It can affect:

  • Reading
  • Sports
  • Math
  • Handwriting

I know because it affects my child.  In 4th grade his writing was terrible and no matter what we did he could not stay caught up.  CI creates struggles in school, problems with eye strain, headaches, and self esteem.  In the end, I even sent him to a different school because I saw him giving up and losing his love of learning due to the every day stresses.  The stress isn’t necessary, but since he looks like a normal child the lack of understanding while he underwent therapy created it.

This is the best video I found for helping people understand what it’s like to suffer from CI.  However, even when presented at the school, they still didn’t quite get it.

What Is Convergence Insufficiency (CI)

Convergence Insufficiency is an eye tracking disorder.  Basically, the left and right eyes do not work well together.  This doesn’t mean the person suffering will look cross-eyed.  In fact, people with CI can often pass a regular eye exam as though they have 20/20 vision.  To make matters more interesting, most general opticians will not detect CI during a routine exam.   A developmental optometrist is a must to rule out CI or properly diagnose it.

Symptoms of Convergence Insufficiency (CI)

  • Difficulty reading
  • Frequently losing your place
  • Double or Blurry Vision
  • Eye strain
  • Difficulty Focusing (this is kind of where the ADHD piece comes in)
  • Headaches
  • + More!

Who Diagnoses CI?

Honestly, I’ve just bring all of my children to the developmental optometrist.  They are the only ones who can diagnose CI at this time.  In addition, I always ask them what my child’s status is for CI.  My younger child is so far sighted that although he passes the exams at school for vision, when it comes to reading he is a mess.  Consequently, he wears glasses all the time due to his far sightedness.  It took us 2 years to rule out CI in his case due to the adjustment required for his eyes as we implemented the corrected lenses.

Finding an eye doctor that is qualified to test for CI is not always easy, depending on your location. In the last few years testing for disorders like CI has become more common and it is getting easier to find a quarried practitioner.  The College of Optometrists on Visual Development website  is an excellent resource to locate the right provider for your child.

There are several tests used to diagnose CI. My favorite is the reading test.  There is a computer program where your child reads specific lines while a special set of glasses tracks their eye movements and the amount of track backs.  At the end of the test, they can play this reading back in a way you can actually see how their eyes track through text.  It is very enlightening.

Treating Convergence Insufficiency

Once a CI diagnoses is made, they can begin treatment in a couple of ways.  One is with the addition of glasses.  For my son, the glasses provided limited support.   However, the second is through a regimen of vision therapy.  Unfortunately, not all vision therapy is created equally and our initial experience resulted in him “graduating” but still struggling at school due to several  gaps in the therapy. It’s also important to note that tracking affects both an academic level as well as in sports.

Initial vision therapy efforts consisted of Brock Beads.  It involved focusing on the bead in a specific way to encourage the eyes to work together.  There are cards where you train your eyes to look only at certain points.  Charts that are read first with one eye, then the other, and finally with both.  An exercise known as a “pencil pushup” also meant to strengthen.  However, the program that focused only on these activities still left holes in vision.  A program that incorporates macro therapy such as tracking a ball during catch in particular ways seems to provide a more well rounded result.  The second program my son enrolled in had a therapist also knowledgable in sports medicine.  By the time he completed his training, all the gaps filled in and reading became more enjoyable.  I owe them so much!

Brock Beads – used in vision therapy

Ways CI Affect Schooling

CI affected my son’s school in a variety of ways.  Some ways are obvious and some a little less so.  One of the biggest affects is his confidence.  Teachers telling him he is lazy or making excuses.  In fact in 4th grade, despite documentation outlining the disorder a teacher still had the ill taste to actually pound on a table saying “You need to have him tested.  There is SOMETHING wrong with him because sometimes he just stares off in space and it’s not normal.”  I simply said. “You’re right and I did have him tested he has CI.  What do you do when your eyes hurt? You relax them.”

1.  Handwriting

My son’s handwriting was horrible.  Each letter spaced a finger space apart regardless of words, sentences, etc.  Letters could be located above, below, on, or with the actual paper lines running right through them.  To write a paper was very painful and took hours upon hours.  This would only be compounded by the effort reading to create reports took.  Creating a legible product often took immense time and effort.

Handwriting sample of a 4th Grader with CI

2.  Math

My son has always been good at math.  It is his “thing”.  However, shrugging with CI, math tests especially in the primary grades were awful.  Often in the younger grades you have sheets of timed math problems the kids must work through.  His teacher, of course, assumed he was lazy or didn’t know certain problems because he would just NOT do some of them.  In reality, his eyes actually skip these problems.  I witnessed this myself on several occasions while he was practicing for these timed tests.  Unfortunately, there is NOTHING that can be done to assist in this past training his eyes OR I found blowing up the sheets.

3. Reading

This is an obvious one because if you are retracing all of your visual steps not only does it slow you down, but you’re also missing words.  My son was able to glean the meanings from the paragraphs without being able to read everything.  Without having a page blown up for him, he read in the 4th grade at a beginning of 1st grade level.  Once a sheet was blown up to an easier size he could read at near grade level.  I’m not sure how though having missed so many foundations!

4. Note Taking

Taking notes from the board was an HUGE impairment because my son would lose his place each time he attempted to look back and forth.   This equals missing items and illegible handwriting.  One way of mitigating the issues simply is using classroom technology to take an image of the notes or assignments.  These images are uploaded to the cloud, keeping me on the same page as the classroom.

There are several ways that CI can affect your child.  Among the resources in my tool kit for explaining to others the battle my child goes through with CI are pamphlets and videos.

Resources

There are tons of good things out there on the internet.  I’ve already referenced several above, but the BEST documentation I’ve found that can be printed and brought into school with you is located at the Vision Therapy Center. This outlines the ways it can affect them in school, shows samples of some of the crazy handwriting, and explains simply but in-depth the entire disorder.

I’m more than happy to connect with anyone who would like to explore this topic further or answer questions based on our journey.  I plan to include a post with my son’s full story on how he’s beat his CI.

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