Binocular Vision Should Be Examined

Prof. Schulte-Körne’s review article mentions the disastrous situation of school students with learning/behavioral disorders and psychological abnormalities and suggests ways to tackle this dilemma. However, unfortunately he does not investigate their somatic causes (1). In my ophthalmology practice, which specializes in binocular disorders, I deal on a daily basis with adolescents with the learning disorders dyslexia or legasthenia who manifest both aggression and depression, ranging up to the threat of suicide, as a result of their problems at school. After correcting visual defects, it has often been possible to improve dyslexia and school performance to such an extent that their psychological state has improved and they have remained in the same class, referral to a special school has been avoided, and many have been able to advance to further education with a normal school career. A majority of these adolescents had already tried every conceivable aid, and their parents were desperate and grasping at straws. In general they had already undergone occupational therapy, speech therapy, psychological treatments, and psychiatric treatments, but success was elusive until the visual defect, usually uncorrected astigmatism and uncorrected associated heterophoria, was corrected with glasses and prisms. Only this has put an end to excessive demand on the visual system—as well as the resulting severe exhaustion, usually also accompanied by chronic headaches—and made normal life possible (2, 3).

Before psychotherapeutic measures, I therefore recommend careful examination of binocular vision, preferably following associating measurement and correction methods according to H.J. Haase using the Polatest (4). The usual written certificate of 20/20 vision is not sufficient in these cases, as this does not reveal eye strain caused by fusion.