Because ADHD and some vision problems share a number of symptoms, there is a risk of misdiagnosis. While ADHD (Attention Deficit Hyperactivity Disorder) and other similar developmental issues are more likely to be seen as the cause of struggles in the classroom, vision problems can cause many of the same symptoms, such as trouble focusing while in class, fidgeting in their seats, and making careless mistakes. Reading, in particular, is a task made much more difficult by a number of vision issues, and in particular by convergence insufficiency.
There are a few symptoms commonly seen in both children with vision issues and children with ADHD which you can watch for.
Because the eyes and the muscles which control them must work together in order for vision to function properly, if there is a problem causing them to work extra hard, they can become sore. This in turn can cause headaches, in addition to pain around the temples or tightness in the neck and the back of the head. Headaches and other pain are more likely to occur, in the case of vision problems, following extended periods of close-up work, such as reading.
Headaches, particularly migraines, are a common symptom of ADHD as well, though in those cases they are not caused by the eyes needing to work extra hard, rather more related to hormonal imbalances or anxiety.
If a child’s eyes have to work extra hard to make sense of what they are seeing, the strain can lead to a number of issues including increased difficulty focusing on images, blurred vision, double vision, and dry or sore eyes.
As ADHD is not a vision issue, it will not cause eye strain per se, but it does also lead to difficulty focusing on tasks such as reading, which can include having trouble focusing the eyes on a task.
If your child tires quickly while reading, it can also signify a vision issue. If the eyes aren’t working together properly, or there is another vision problem making the task before them harder, the child will have to utilize much more energy. It is not unheard of for children dealing with such issues to even fall asleep while reading.
ADHD can lead to fatigue for a number of reasons, including anxiety, increased energy expenditure due to hyperactivity and over-focusing, and neurotransmitter regulation issues.
Vision issues are often comorbid with ADHD, but there is no evidence that either one causes the other. There are children with 20/20 vision who have ADHD, and children whose learning difficulties are solely caused by vision issues. Similarly, a child can simultaneously have a vision issue along with ADHD.
Recent studies show that children with vision issues are twice as likely to be diagnosed with ADHD, and a 2000 study found that children diagnosed with convergence insufficiency were three times as likely to have ADHD.
While it is clear that they are often found together, there are questions to be asked regarding whether this correlation is because they are both actually present simultaneously, or whether a percentage of children with a vision issue are being misdiagnosed with ADHD before a vision issue which could account for their learning difficulty is discovered.
Because there are vision issues, such as convergence insufficiency, which can result in similar learning difficulties, it is possible that a child will be incorrectly thought to have ADHD. The fact that ADHD is a much more well known problem makes this error all the more likely.
If your child is suspected to have ADHD, it is important to consider other issues that might be causing the problem before assuming that ADHD. One of the first things that should be done when it becomes clear that your child is having learning difficulties is to get them a comprehensive eye exam.
The biggest danger of a child being wrongly diagnosed with ADHD is the effects of the medication, such as Ritalin or Adderall) that are commonly prescribed. In addition to the numerous side effects of these medications, the intended effects of them can be harmful to children who do not need them.
Additionally, there is still a stigma associated with learning disabilities like ADHD, and it can be harmful to a child’s self-esteem if they believe they have ADHD.
While it is important not to rush to judgement so as to avoid potential misdiagnosis, it is also important to act promptly. The more time that passes, the problem can get worse, your child’s academic performance can suffer more, and the condition can seriously damage their self-confidence at an age where it is important for them to be building it up.
Stay in contact with their teachers, and be sure to have your child’s vision professionally evaluated regularly (in-school screenings will not cut it.)