Wednesday, July 29, 2009

The Eye M.D. association's inaccurate statement about Dyslexia and Vision

I guess it is too much to expect M.D. Ophthalmologists to actually be able to think their way out of a scientific bag. I expect to be slapped around for my comments here but I actually think that just because people have a biased opinion about a subject they shouldn't expose themselves by acting as if they can make a scientific sounding policy about dyslexia and vision unless they actually understand dyslexia as well as vision and the fact that a minority of dyslexics can describe individually specific visual problems that make reading difficult.

Here is the link to the new policy saying that vision has nothing to do with dyslexia

I see Sally Shaywitz and her husband's fingerprints all over the policy statement. I have always said that phonological problems are indeed the most common dyslexia problem ( regardless of the fact that there are a non trivial amount on non responders to phonological interventions)and that if you want to blindly choose an individual selected in a random manner from a group of dyslexics that phonological intervention has the greatest statistical chance of being helped. That method fails for a non trivial amount of dyslexics sometimes because of visual problems seeing text.

That Shaywitz uses fMRI information to prove the phonological problem relationship to dyslexia in her certain manner while not being able to identify if an individual is dyslexic or not by that method suggests to me that she is reading a little more certainty into the data than is there. I am not trying to criticize her, her star is at its height right now and the AAO believes her as if it is written in stone.

This is going to be a long post so I am going to go out on a limb and say that in all of history that there has never been any single way that Doctors have treated a large group of kids (or people in general) so that the results have been positive for every kid. I am not saying that groups haven't been helped just that a certain amount of collateral damage is acceptable. I guess that is why it is OK to promote drugs that may cause death in a few people as a side effect and OK to promote a single phonological intervention for dyslexics that will have some non responders to the intervention.

Sometimes it is informative to actually read the references that are used to evaluate them for quality and make sure they are inclusive of the information to date. GF Eden did one of the first fMRI studies on dyslexia and vision and found about the same differences that are seen in other areas of the brain : you can see differences between groups of dyslexics and non dyslexics. That study was big news at the time I would think the everyone belonging to the Eye MD association would be familiar with the study. G. Eden went on and studied other areas of the brain related to reading and found the same differences as with vision. The eye MD's included one of Eden's studies just not the one on vision. I always liked the comment from a young girl in her study who said she could read if the words would just stop walking. I have a vested interest in this discussion because I sell glasses that would stop those letters from walking so that girl could read normally.

I can understand the eye MDs being upset with the low quality studies done on vision therapy and colored lenses but just as poor studies don't prove anything positive they also don't prove anything negative. It is not proper to conclude that because a study is very flawed that it proves that something doesn't work, it just still needs to be properly studied.

I have no idea about how effective vision therapy is. Personally, I believe there is no way that claims of 80% of learning problems are vision related can possibly be true so there has to be huge failure rates and since it can take months and thousands of dollars and is never guaranteed I would advise against it until a target group can be identified so that the success rate can be raised to the point that a guarantee could be offered. I just don't see that vision therapy is a viable product at this time.

I don't like the lack of a guarantee and the overselling of colored lenses either. Again the studies done with colored lenses have been poorly designed but are suggestive that a better selected at risk population could increase the success rate. The eye MDs just can't claim that poorly designed studies prove a negative when they don't prove anything.

Just because the eye MDs are embarrassed that anyone would invade their turf with big claims little proof and no guarantees doesn't give them the right to speak from the mount and spew poorly researched and selected articles to get rid of the invaders.

Since I sell and financially guarantee that See Right Dyslexia Glasses remove described visual problems that make reading difficult for a minority of dyslexics I have a dog in this (fight) discussion.

Statistically, dyslexics in general and visual dyslexics in particular have a higher rate of poor depth perception. My glasses restore normal depth perception for that group. It seems that eye MDs can't restore normal depth perception yet but they can measure depth perception. Feel free to challenge my glasses ability to do that if you find a dyslexic with poor depth perception. I run across them occasionally myself.

I think using the FAQ's on a dyslexia site as a reference indicates a sloppy gathering of information to develop a national policy on dyslexia and vision not being related. Also since Eden's study on dyslexia and vision indicating dyslexia and vision are related was of the same excellence as the one you used as a reference
I wonder if the eye MDs did more than read the abstracts. Eden often mentions the non universality of her results as pertains to dyslexics.

Put the policy back on the agenda and do a better job next time. Here is some info on visual dyslexia.