1. Failing to see the problem
Allen thurston,
professor of education,
director of centre for evidence & social innovation

2. Aims of the day
Look at whether poor vision might influence learning to read
Look at research data to tell us the extent of the issue
Look at why this might not get picked up through traditional screening
Think about what we could do to address the issue

3. Aims of the day?
Look at whether poor vision might influence learning to read
Look at research data to tell us the extent of the issue
Look at why this might not get picked up through traditional screening
Think about what we could do to address the issue

4. What are the main issues?
Colour blindness
Hyperopia
Myopia

5. How does poor vision influence us? (www.webmd.boots.com)
Difficult to distinguish green and red colours
Tends to only affect male students

6. How does poor vision influence us? (www.webmd.boots.com)
Myopia (can’t see near things clearly)
Hyperopia (can’t see far away things clearly)

7. Why are images blurred? (www.webmd.boots.com)
Myopia (can’t see near things clearly)
Hyperopia (can’t see far away things clearly)

8. How does poor vision influence us in the classroom. (www. sightsavers
How does poor vision influence us in the classroom? (

9. How does poor vision influence us in the classroom. (www. sightsavers
How does poor vision influence us in the classroom? (

10. Accommodation (www.gsu.edu)
Small muscles contract and the lens changes shape
Brings focus for a short time

11. How do we measure refractive error?
Lens strength
Diopters
+1.25 glasses that magnify slightly
+2.5D glasses that would be essential for reading the paper
+3.5D glasses that are essential for reading your text messages on full magnification

12. What is the extent of the problem?
The Royal National Institute of Blind People (RNIB)
UK estimates at 20% (Solebo & Rahi, 2013)
Mather Elementary School, Boston, USA 50% detected (Orfield, 2001)
23% of 6-7 year-olds in Northern Ireland detected
11% of year-olds in Northern Ireland (O’Donoghue et al., 2010, 2012)

13. Why aren’t these children picked up by screening?
In some cases they are not detected
Poor screening with no account of ‘accommodation’
Poor availability of expensive portable equipment e.g. auto- refractometers
Screening by nurses or orthoptists who can not prescribe
Poor uptake of prescriptions by parents
No follow up to see if prescription filled

14. Why aren’t these children picked up by screening?
Not wearing glasses
Only between 20-30% of students wear glasses one year on (Preslan and Novak, 1998)
Parents do not take screened children to the opticians (Scottish Government, 2010)
2229 children screened during the 2000/01 in Michigan, USA- 25% went to the optician

15. Is poor vision associated with poor reading?
A study of 1298, 8 year-old children in served by Rhondda Cynon Taff Community Paediatric Service, Wales
Students with new diagnoses of hyperopia (refractive errors +1.25D in one eye) were about 3 months behind national assessments in literacy (SATS) than comparator groups with no vision problems
Students with new diagnoses of hyperopia (refractive errors +3D both eyes) were about 18 months behind national assessments in literacy (SATS) than comparator groups with no vision problems
30% of this sample had been referred to educational psychology services to investigate developmental delay (Williams,Latif,Hannington&Watkins, 2005)

16. Is poor vision associated with poor reading?
In a study of vision and academic performance of students from Iowa, USA
Regression analysis indicated that visual factors were a stronger predictor of student performance than ethnicity or socio-economic status
Hyperopic students were about 9 months behind (Maples, 2001).

17. Is poor vision associated with poor reading?
191 Year 1 students in Ohio, USA (mean age 7.78 years)
Significant correlation between low vision and Stanford Reading Test
Hyperopic students were about 8 months behind (Kulp,1999)

18. Is poor vision associated with poor reading?
782 Year 1- Year 5 students (age 5-11 years) looking at relationship between reading development and visual errors (USA)
Hyperopic students were 6 months behind students with no refractive error
(Rosner & Rosner, 1997)

19. Would glasses help?
Ice-cream sales and murders are correlated in the USA

20. Would glasses help? Randomised controlled trials are rare
Effects of screening and treatment by glasses and patching of 177 three-year- old to five-year-old children
Made gains of between +8 and +18 months progress on ability to read letters and symbols six months following examination (Clarke et al., 2003 )
Conlon (2016) has completed a randomised controlled trial in China and found gains of +3 months for children presscribed glasses for myopia

21. Implications Take care with coloured text and pens
Seeing the blackboard can be difficult for hyperopics
Sit them closer to the blackboard/interactive white board
Reading books can be difficult for myopics
Hold the book very close
Accommodation helps focus
Both hyperiopics and myopics could benefit from spectacles
Consider relationships with opticians
Testing and prescription

22. Questions