Am Orthopt J    42:159-164 (1992)

Elusive Neuro-Ophthalmic Reading Impairment

Katherine J. Fritz, C.O., Michael C. Brodsky, M.D.

"Difficulty reading" is a common ocular symptom in patients of all ages. To the orthoptist and ophthalmologist, this complaint usually signifies presbyopia, uncorrected hyperopia, or convergence insufficiency. In most patients, the underlying condition is quickly identified, and easily remedied with either bifocal correction, hyperopic spectacles, or convergence exercises. A more complex group of patients with reading impairment falls into the dyslexia/minimal brain dysfunction category of non-neuroophthalmic language acquisition disorders. Once an ocular etiology has been ruled out, diagnosis and treatment of these patients is within the province of psychologists and special education instructors.

This discussion concerns four neuroophthalmic disorders that produce reading dysfunction as an early manifestation, but that are easily overlooked unless their associated neuroophthalmic signs are specifically sought. Each condition produces distinct visual-sensory or ocular-motor disturbances that interfere with a complex series of neurophysiologic events that normally take place during reading. We examine these disorders with regard to the pathophysiology of reading impairment they produce, their associated neuroophthalmic signs, and the clinical examination techniques that facilitate their diagnosis.

© 1992 The Board of Regents of the University of Wisconsin System
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