Reading difficulties and the pediatric ophthalmologist.

Approximately 20% of children have dyslexia, a language-based reading disability. A variation in language processing in the brain leads to a deficit in phonological (auditory) processing, which leads to problems in learning to read, write, and spell. Myths continue to exist regarding dyslexia and vision, and although eye and vision problems may coexist with dyslexia, they are not more prevalent than in the general population. Rarely vision problems may make reading at near very difficult and may masquerade as a learning problem or attention deficit disorder/attention deficit hyperactivity disorder. The pediatric ophthalmologist can play a valuable role in determining whether any eye or vision problems exist that might interfere with learning or reading. Treatments to improve these eye conditions may help make reading more comfortable, but they are not a therapy for coexisting dyslexia. The use of vision therapy has never been shown scientifically to be effective and may prevent the application of effective interventions during the critical period of development when reading disorders can best be remediated. The pediatric ophthalmologist should educate parents about reading and dyslexia and provide prompt referral to professionals who have expertise in evaluating and treating learning disabilities.