Difficulty reading is one of the main reasons that people seek vision care. There are many causes and types of reading problems, and the specific treatment depends on an accurate diagnosis. Listed below are some of the more common visual causes of reading problems and an introduction to treatment.
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Convergence Disorders Affecting Reading
Convergence (eye teaming and coordination) problems will impair reading ability. Difficulty with the eyes working together can cause double vision, eyestrain, fatigue or the appearance of words seeming to move and swim on the page when reading. Options for treatment include lenses, prisms and therapy.
Accommodation Disorders Affecting Reading
Accommodation (focusing) problems will impair reading ability. Difficulty with how the eyes focus can cause blurring, eyestrain, fatigue or the appearance of words seeming to pulse and float on the page when reading. Options for treatment include lenses and therapy.
Reading Problems Due to Visual Field Loss
Visual field (peripheral vision) loss will often interfere with reading ability. Patients often lose their place and miss words to the side of the loss while reading. Treatment options include the use of special prisms, scanning therapy and compensatory reading techniques.
Visual Impairment Causing Reading Problems
Visual impairment (loss of visual acuity, for example with macular degeneration) will impair reading. The problem is directly related to clarity of sight, and increases reading difficulty. Therapy options aim at enhancing visual acuity. Low vision techniques including special microscopic lenses, telemicroscopes, magnifiers and electronically closed circuit television systems, all of which may help the patient read again.
Diplopia Causing Reading Problems
Diplopia (double vision) is the most bothersome and intolerable of vision problems and will impair reading. There are many types of diplopia (see section on double vision). Treatment options include lenses, prisms, partial selective occlusion and in very rare circumstances, surgery.
Eye Gaze Disorders Affecting Reading
Eye gaze disorders, called ophthalmoplegia (paresis or paralysis of eye muscles that limit ability to move the eye in certain directions) will affect reading. Patients with inferior gaze problems may not be able to look down into their bifocal. Patients with lateral gaze problems may experience scanning problems or diplopia. Treatment options include lenses, prisms and compensatory reading strategies.
Eye Movement Disorders Affecting Reading
Saccadic (scanning) movements of the eyes will impair a person’s ability to read when they are dysfunctional. Saccadic disorders manifest as jerkiness or slowness of movement and may cause the eyes to jump erratically when reading. Treatment is with eye movement therapy to help improve these movements.