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There are two situations in which the term dyslexia now commonly applies. The first is when the reader has difficulty decoding words (i.e., single word identification) and encoding words (i.e., spelling).^35,36 The second -- a frequent presentation in optometric practice -- is when the reader makes a significant number of letter reversal errors (e.g., b - d), letter transpositions in words when reading or writing (e.g., sign - sing), or has left-right confusion.³⁷6 Learning Related Vision Problems6. Visual Efficiency and LearningVisual efficiency is related to learning, and the avenues for visual efficiency problems to impact learning potential are numerous.^41-43 Eye discomfort may make it difficult to complete school tasks or homework assignments in a timely manner. Distraction or inattention may become secondary complications. Task avoidance is a frequently overlooked effect. The presence of severe asthenopia during visual tasks can lead to less time on task, decreasing the opportunity for practice and learning, particularly in vocabulary development, comprehension, and reading mechanics. A harmful associative relationship between eye discomfort and the learning activity can develop, leading to disinterest and poor motivation for traditional learning activities.Blurred, diplopic, or distorted text can be expected to decrease word processing speed and efficiency, reduce reading rate, and compromise reading comprehension. Inadequate attention allocation for information processing can exist when attention is diverted to manage the visual efficiency problem at the expense of the ongoing processing required for learning. The proliferation of computer-assisted instruction in the school setting -- notwithstanding the dramatic increase in computer use at home and school -- has created an even greater demand for visual efficiency.7. Visual Information Processing and LearningThe importance of visual information processing skills for learning is self-evident.^44-46 Visual information processing skills provide the capacity to organize, structure, and interpret visual stimuli, giving meaning to what is seen. Veridical visual information processing leads to perceptual constancy, creating a stable and predictable visual environment. These are important attributes for every learning situation. Visual information processing skills considered separately and collectively are related to learning ability and contribute to the total variance in academic achievement.^47-58 Individuals with learning problems can present with distinct patterns or combinations of visual information processing deficits.Statement of the Problem 7 8. Timing of Vision Related Learning ProblemsDuring pre-school and the early school years, academic instruction places relatively greater demand on a child’s visual information processing skills.⁵⁹

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