When visual problems are not remediated, they may manifest as ADHD behaviour. Underlying visual difficulties (such as convergence insufficiency, eye tracking) should be treated if any. These problems are usually covert and not well understood by child as well.

Relationship between Convergence Insufficiency (CI) and ADHD

In 2005, Dr. Granet studied 266 patients with a common near vision disorder called convergence insufficiency (CI). The study found that nearly 10 percent of subject with CI also had diagnoses of attention deficit hyperactivity disorder (ADD or ADHD). At the time of the study, Dr. Granet and his colleagues stated that this was three times the percentage of ADHD found in the general population. Estimates of ADHD in the population have continued to trend upward since 2005.

Dr. David Granet, a professor of ophthalmology and pediatrics at the University of California, San Diego, said:

“Everyone is familiar with A.D.H.D. and A.D.D., but not with eye problems, especially not with convergence insufficiency. But we don’t want to send kids for remedial reading and education efforts if they have an eye problem. This should be part of the protocol for eye doctors.”

“When five of the symptoms of A.D.H.D. overlap with C.I. (convergence insufficiency),” he said, “how can you not step back and say, Wait a minute?”

Dr. Granet also commented, “We don’t know if convergence insufficiency makes ADHD worse or if convergence insufficiency is misdiagnosed as ADHD. What we do know is that more research must be done on this subject and that patients diagnosed with ADHD should also be evaluated for convergence insufficiency and treated accordingly.”

DSM-IV Criteria for ADHD:

1. Often does not give close attention to details or makes careless mistakes in schoolwork, work or other activities.
2. Often has trouble keeping attention on tasks or play activities
4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
6. Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
8. Is often easily distracted.”

Comparing the Convergence Insufficiency Symptom Survey with the DSM-IV criteria for ADHD, 5 of the 9 symptoms of inattention could also be applied for CI (symptoms 1, 2, 4, 6 and 8 as above). As there is a significant overlap in symptoms, it is not hard to imagine a diagnostic confusion.

A child with ADHD can have poor visual skills too. By improving their foundation in visual skills,  Learning can also be improved.

​At Vision and Perception Practice, we provide the latest equipment and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.