ADHD or Convergence Insufficiency?

There are 9 major symptoms used to diagnose ADHD in children:

  1. Often fails to give close attention to details or makes careless mistakes in schoolwork
  2. Often has difficulty sustaining attention in tasks
  3. Often does not follow through on instructions and fails to finish school work
  4. Often avoids or is reluctant to engage in tasks that require sustained mental effort
  5. Often easily distracted by extraneous stimuli
  6. Often does not seem to listen when spoken to directly
  7. Often has difficulty organizing tasks and activities
  8. Often loses things necessary for tasks or activities
  9. Often forgetful in daily activities

Of these nine symptoms, five of them (numbers 1 – 5) overlap with the symptoms of a common visual disorder called convergence insufficiency, which is where the eyes can’t turn in together to focus on nearby objects. I wrote about convergence insufficiency in a previous blog post.

That is an undeniably large overlap of symptoms. Convergence insufficiency is three times more likely in children diagnosed with ADHD than those without. Studies have shown that 60% of children diagnosed with a learning problem actually suffer from undetected vision problems, like convergence insufficiency.

Part of the problem lies in the medical profession, where doctors too quickly jump to the diagnosis of a learning disability without assessing other possibilities. Another part of the problem is a misunderstanding of vision testing. Parents take their children in for regular vision tests and are told that their child has 20/20 vision, so they assume vision isn’t a problem. But those basic vision tests don’t test for problems like convergence insufficiency, so these problems go undetected.

When children with convergence insufficiency read or focus on something up close, it’s difficult and tiring on their eyes so they get frustrated. This frustration can lead to them appearing inattentive and with symptoms similar to ADHD. The vision problem manifests as inattention because a child is physically uncomfortable staying on task.

Of course, this doesn’t mean that all children diagnosed with ADHD have been misdiagnosed. But there are signs you can look for. One of the biggest signs a child might have a vision problem rather than a learning disability is that they have trouble at school but not at home. Another sign is if the child is particularly clumsy.

If you suspect your child might have a learning disability like ADHD, or if they have been diagnosed with one, it’s definitely worth taking the time to get a comprehensive vision test from a trained Optometrist. 

By Dr. Nazima Sangha of Family Eyecare Centre