Can Vision Problems be Misdiagnosed as ADHD?

Dr. Russel Lazarus, March 8, 2020

While many children with ADHD have 20/20 vision, they may still suffer from vision problems that affect their ability to learn.

Functional vision difficulties can produce similar symptoms to those found in ADHD (i.e. difficulty focusing in school, tendency to fidget or squirm in their seats, making careless mistakes, etc.). Other visual problems can lead to skipping lines, confusing words and word-order, etc. — making it impossible to read accurately.

The most common vision condition that produces symptoms similar to those that present with ADHD is called Convergence Insufficiency (CI).

Convergence of the eyes occurs when the two eyes work as a team to focus on an image for clear vision. Convergence insufficiency requires the eyes to work harder to process visual information accurately for clear vision.

Diagnosis and treatment of CI is essential for your child’s success in reading, learning, sports performance, and more.

It is important to note that a child can have perfect 20/20 eyesight, or wear glasses to improve near/distant vision, and still suffer with CI. Therefore, a child that presents with symptoms of ADHD should have his eyes examined to detect any signs of CI.

Vision therapy has been shown to improve the symptoms of convergence insufficiency.

Contact a vision therapy eye doctor near you if your child is showing signs of ADHD.

SEE RELATED: Does My Child Have ADHD?

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Consequences of a misdiagnosis

An incorrect diagnosis of ADHD can result in serious consequences, including prescriptions of strong medications to treat ADHD (such as Ritalin or Adderall).  These medications alter dopamine levels in the brain to increase focusing ability and concentration levels.

However, the side effects of these medications can include sleep disruptions, nausea, loss or increase of appetite, mood swings, and even depression. Moreover, a diagnosis of ADHD can result in stigmas and negative behaviors from peers — possibly leading to reduced self-esteem and confidence levels.

What is functional vision?

Functional vision is best understood as the set of visual skills that a person uses to gather and process visual information.

In other words, functional vision is how your entire visual system — the eyes, the brain, and the visual pathways work together, to help you accurately interpret visual information, and interact with your environment.

Functional vision skills that are most often affected by ADHD include:

  • Eye teaming
  • Focusing
  • Hand-eye coordination
  • Visual perception
  • Visual tracking

Signs of reduced functional vision skills

Studies show that children with a vision impairment are twice as likely to be diagnosed with ADHD as compared to their peers.

When a child has reduced functional vision skills, certain symptoms and behaviors can appear:

Difficulty paying attention in class. Regular classroom tasks become much more challenging —leading to feelings of frustration, tiredness, or an inability to sit still.

Reading below grade level. Difficulty with eye teaming and focusing can make reading difficult and uncomfortable— resulting in reading at a slower rate, or avoiding the task altogether.

Loss of concentration. Difficulty focusing on the board can cause a reduced ability to maintain concentration, and may result in ‘daydreaming’ or distracting classmates.

Rushing through school work. Reduced functional vision causes difficulty with reading and writing tasks. As a result, children may rush through their assignments, making careless mistakes in their work.

Difficulties playing sports. While playing sports, it is important that the player be able to accurately judge the position and path of the ball, and other equipment. This is difficult for children with reduced functional vision because their ability to follow a ball as it flies through the air, or assess the physical distance between players, is affected.

More symptoms of reduced functional vision skills:

  • Excessive squinting
  • Frequent rubbing of the eyes
  • Lack of interest in reading

How can I help my child?

Schedule a functional vision assessment to determine whether your child’s signs of ADHD are due to an undiagnosed vision problem.

LEARN MORE: Vision Therapy for ADHD

A comprehensive diagnosis and treatment of any underlying vision problems can facilitate your child’s academic and personal success.