Does your child daydream too much in class?

12 September 2017

What factors might contribute to some children appearing to drift away from concentrating on their lessons more than others? Obviously there can be many reasons, some transient such as a late night or poor quality sleep the night before, the lesson being of too high and complicated a level that the child loses the plot or conversely too simple and easy that they're bored, or no breakfast so that their blood sugar has plummeted.
But might there be visual reasons why concentration can't be maintained? Studies in the USA have shown that one of the commonest causes of attention deficit symptoms is weak or poorly controlled convergence.

Think of your own eyes when you are looking at a far away object. They are likely to be feeling relatively at rest and someone looking at you would see that each eye is placed centrally between the lids and with a limited amount of the 'white' of the eye (the sclera) visible on each side of the coloured part (the iris visible through the clear cornea). But bring your own finger up in front of you, about 30cm away from your face, and stare at the finger. Think about how your eyes feel now. Still comfortable? A little more effort? Is the finger clear and single? Then bring the finger nearer in towards you, and again feel the difference. Is there a point at which you start to see the single finger appear to separate into two fingers? Look at someone else doing this and you can observe a great difference in the positioning of the eyes within the lids, much nearer together and each nearer the bridge of the nose, than when the person looks away into the distance. The convergence is the effort required to activate that movement, and for some children their convergence is weak so that their eyes slip outwards and the near object appears to double up or at the very least, wobble in front of them.

Now, think how much of that convergence effort is required to keep the two eyes looking together at a word on a page of a book held, maybe, less that 20cm from their nose, and it's not hard to imagine what hard work that is and why for a proportion of youngsters, so much easier and less stressful to look up and stare away into distance. Their attention wanders, they don't know why but they dislike looking at those confusing squiggles swimming a little on the page. They may experience headaches, often at the sides of the head, and become fatigued more quickly.

So, can anything be done? Yes; an exceptionally well controlled study in the USA over several years showed that the best 'cure' for CI (American for convergence insufficiency) was in practice optometric Vision Therapy. This involves the child working actively on guided exercises to improve the way their two eyes worked together at near over a period of weeks or months. Sometimes spectacles were also required.

If you are a teacher with a youngster constantly looking out of the window in your class, or a parent whose child is described as having poor attention at school then consider CI as a possible cause, and seek a comprehensive visual assessment from a Behavioural Optometrist. See

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