Research
The science behind our approach
Research behind our evidence-based Reading Vision Tutoring approach
Eldon McMurray (Doctoral Dissertation)
SUMMARY: Underperforming students receiving training in Critical Thinking and Reading Strategies subsequently outperformed their more advanced peers in Degrees of Reading Power tests.
Eldon L. McMurray, Elaine Carter
SUMMARY: If you have read a textbook and felt confused and/or frustrated, or you couldn’t fully understand what you were reading or remember what you needed to learn, this book provides the critical thinking, reading, and writing strategies most essential for you to succeed.
Statistical Claim: "Experts estimate vision problems are prevalent in 25% of all schoolchildren in the United States and are one of the most prevalent handicapping conditions in childhood."
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Statistical Claim: "It is estimated that up to 85% of at-risk children have undetected or untreated vision problems."
This statistic is largely derived from clinical studies observing special education populations, children with IEPs (Individualized Education Programs), and Title I reading students.
The Research: Dr. Joel Zaba, a prominent optometric researcher, conducted highly cited studies in the late 1990s and 2000s evaluating the visual systems of children struggling academically. In his research on children who were reading below grade level, he found 25% of school children in the US have a vision problem, and that of Title I students in the fifth through eighth grades, and academically and behaviorally at-risk children ages 8 to 18, up to 85% of these children had vision problems that were either undetected or untreated. Zaba, Joel. (2011). "CHILDREN’S VISION CARE IN THE 21ST CENTURY & ITS IMPACT ON EDUCATION, LITERACY, SOCIAL ISSUES, & THE WORKPLACE: A CALL TO ACTION." Journal of Behavioral Optometry. 22. 39.
Statistical Claim: "Vision problems are often mistaken for dyslexia, ADHD, or low motivation."
The Research: A study published in the Journal of Behavioral Optometry found that a disproportionate number of children labeled as "problem learners" or diagnosed with ADHD/learning disabilities actually suffered from uncorrected binocular vision issues that mimicked attention and learning deficits.
Statistical Claim: "The majority of the vision problems that interfere with reading and learning are very treatable." And, "Many of the vision problems that interfere with reading can be corrected in a couple of months."
The Research: The gold standard of research supporting this statement is the "Convergence Insufficiency Treatment Trial (CITT)". Published in the Archives of Ophthalmology (2008), the CITT was a landmark, multi-center, randomized, double-blind clinical trial funded by the National Institutes of Health (NIH) and the National Eye Institute (NEI).
Statistical Claim: "Reading requires eye tracking. Fix the reading problems and fix the reading problems."
The Science: The physical act of reading heavily relies on oculomotor control—specifically saccades (the ability to jump the eyes accurately from word to word) and fixations (holding the eyes steady on a word to process it). When a child has an eye-tracking deficit, they lose their place, skip lines, and expend so much cognitive energy just trying to aim their eyes that reading comprehension and fluency plummet.
The Research: Leong, D. F., et al. (2014). "The Effect of Saccadic Training on Early Reading Fluency." Clinical Pediatrics, 53(9), 858–864. In this randomized, controlled trial, elementary school students who struggled with reading underwent a 6-week saccadic (eye-tracking) training program using specialized software. Post-treatment, the treatment group showed significantly higher reading fluency scores compared to the control group. The researchers concluded that rigorous practice of eye movements and shifting visual attention is vital to the act of reading, and fixing this physical deficit directly improves reading fluency.
Statistical Claim: "Eye-movement problems and reading intervention can be addressed concurrently."
The Science: A major misconception is that vision therapy "cures" learning disabilities like dyslexia. It does not. Vision therapy fixes the input mechanism (the eyes and brain gathering visual data), while reading interventions (like phonics) fix the language decoding mechanism. Standard clinical guidelines strongly recommend a multidisciplinary approach where optometric vision therapy and educational tutoring are done at the same time to maximize neuroplasticity and academic success.
The Research: Jafarlou, et al. (2024) "Oculomotor Rehabilitation Improves Reading Abilities in Dyslexic Children With Concurrent Eye Movement Abnormalities" Clinical Pediatrics. 2024;63(9):1276-1286. In this randomized clinical trial of 50 dyslexic children, the positive effects of oculomotor rehabilitation on the reading performance of dyslexic children confirmed that the oculomotor program could be a practical tool for improving reading performance in dyslexic children.
Statistical Claim: "Visual processing problems can be hereditary, caused by physical trauma or concussion or head injury."
The Science: Visual processing and oculomotor dysfunctions have diverse etiologies. Certain binocular vision problems (like strabismus/eye turns, amblyopia/lazy eye, and severe refractive errors) have strong genetic and hereditary links. Conversely, acquired oculomotor dysfunction is one of the most common side-effects of Traumatic Brain Injuries (TBIs), whiplash, and concussions. Because 50% of the brain's neural pathways are involved in vision, any shaking of the brain heavily impacts the visual system.
The Research: (Trauma & Concussion):
Master, C. L., et al. (2016). "Vision Diagnoses Are Common After Concussion in Adolescents." Clinical Pediatrics, 55(3), 260-267.
Found that 69% of adolescents with concussions had associated vision diagnoses (including tracking and focusing deficits), proving that head trauma is a massive driver of visual dysfunction.
https://pubmed.ncbi.nlm.nih.gov/26156977/
(Hereditary):
Sanfilippo PG, Hewitt AW, Hammond CJ, Mackey DA. "The heritability of ocular traits." Surv Ophthalmol. 2010 Nov-Dec;55(6):561-83. Highlights how genetics play a primary role in the development of the eye and visual pathways, proving that traits leading to binocular vision disorders (like strabismus and refractive errors) are frequently inherited from parents.
Statistical Claim: "Unless visual tracking issues are addressed, they will persist."
The Science: Persistent visual symptoms should not simply be dismissed as something a child will outgrow. For children with symptomatic convergence insufficiency, randomized trials support office-based vergence/accommodative therapy with home reinforcement. In patients with persistent concussion-related convergence insufficiency, a randomized trial found substantially greater improvement with immediate therapy than with six additional weeks of watchful waiting.
The Research:
Alvarez TL, Scheiman M, Hajebrahimi F, Noble M, Gohel S, Baro R, Bachman JA, Master CL, Goodman A. "CONCUSS Investigator Group. CONCUSS randomised clinical trial of vergence/accommodative therapy for concussion-related symptomatic convergence insufficiency". Br J Sports Med. 2026 Mar 12;60(5):340-354
What it found: In patients aged 11–25 with persistent concussion-related Convergence Insufficiency, 88% improved on the trial’s clinical measures with immediate therapy, versus 8% during six weeks of delayed therapy and standard concussion care. This supports earlier treatment rather than assuming watchful waiting for another six weeks will solve the problem.
Statistical Claim: Classroom learning relies heavily on strong visual skills.
Coetzee, D., & Pienaar, A. E. (2018). "Influence of Different Visual Perceptual Constructs on Academic Achievement Among Learners in the NW-CHILD Study." Journal of Optometry This is a robust, peer-reviewed study analyzing 581 school-aged children as part of the North-West Child Health, Integrated with Learning and Development (NW-CHILD) longitudinal study. The researchers state that visual perception plays an important and integrating role in the development of cognitive abilities and perceptual-motor skills. The study measured visual-perceptual constructs against real academic report cards and standardized testing.
Crucially, the study found that different visual perceptual constructs did have significant influences on specific areas of academic learning and on academic achievement generally. The final conclusion of the research explicitly states that basic and complex visual perceptual constructs remain important for academic achievement in this age-group.
Statistical Claim: "Seeing clearly (“20/20”) is just one of 15 visual skills critical to academic success."
The Research: This concept is the cornerstone of developmental optometry, tracing back to Dr. A.M. Skeffington, the "father of behavioral optometry," and standardized by the COVD.
https://www.aoa.org/healthy-eyes/eye-health-for-life/school-aged-vision
"20/20" is simply a measurement of visual acuity (sharpness) at a distance of 20 feet (the Snellen Chart).
However, reading a book at a desk requires entirely different physiological mechanics. Research in the Journal of Learning Disabilities and Optometry and Vision Science substantiates that deficits in non-acuity skills correlate strongly with reading struggles.
https://pubmed.ncbi.nlm.nih.gov/15493435/
https://pubmed.ncbi.nlm.nih.gov/8728493/
https://pubmed.ncbi.nlm.nih.gov/8728497/
Reading depends on more than just seeing letters clearly. The eyes and brain must work together efficiently to track words, maintain focus, process visual information, and understand what is being seen.
1) Eye Teaming (Binocularity): Both eyes working together and pointing accurately at the same place so the brain can maintain clear, single vision.
2) Eye Tracking (Saccades & Pursuits): The ability to move the eyes accurately and efficiently across a line of text, shift from word to word, and move to the next line without frequently losing one’s place.
3) Accommodation (Focusing): The ability to maintain clear focus up close and quickly change focus between different distances, such as from a book or desk to a whiteboard and back.
4) Fixation: The ability to keep the eyes steadily focused on a letter, word, or other target long enough to take in the visual information.
5) Depth Perception (Stereopsis): The ability to use both eyes together to accurately judge distance, depth, and the position of objects in space.
6) Peripheral Awareness: The ability to remain aware of visual information outside the exact point being looked at while maintaining attention on the central target.
7) Visual-Motor Integration: The ability to coordinate what the eyes see with movements of the hands and body. This is important for handwriting, copying, drawing, and other classroom activities.
8) Visual Discrimination: The ability to recognize similarities and differences between letters, words, shapes, and symbols, such as distinguishing b from d or identifying small differences between words.
9) Visual Form Perception: The ability to recognize and interpret letters, words, shapes, and patterns accurately, even when their size, position, or appearance changes.
10) Visual Memory: The ability to remember visual information after it is no longer being seen, such as recalling the appearance of a word, letter pattern, or spelling.
11) Visual Sequential Memory: The ability to remember visual information in the correct order, such as a sequence of letters, numbers, words, or symbols.
12) Visual-Spatial Relations & Directionality: The ability to understand where objects, letters, and words are positioned in relation to oneself and to one another, including concepts such as left, right, above, below, and direction.
13) Visual Figure-Ground: The ability to locate and focus on important visual information when it appears within a busy or distracting background, such as finding a specific word on a crowded page.
14) Visual Closure: The ability to recognize a complete letter, word, shape, or object when only part of it is visible or when some of the visual information is missing.
15) Visual Integration & Processing: The ability to organize, interpret, and combine visual information with language, memory, movement, and other information so that what is seen can be understood and used effectively.
Together, these visual skills help make reading more accurate, comfortable, and efficient. A child may have clear eyesight on a standard eye chart while still struggling with one or more of the visual skills required for sustained reading and learning.
Fusco, Germano & Capellini (2015), "Efficacy of a perceptual and visual-motor skill intervention program for students with dyslexia."
https://pubmed.ncbi.nlm.nih.gov/26107077
Palomo-Alvarez C, Puell MC. "Binocular function in school children with reading difficulties." Graefes Arch Clin Exp Ophthalmol. 2010 Jun;248(6):885-92.
https://pubmed.ncbi.nlm.nih.gov/19960202
Quercia P. "Mouvements oculaires et lecture: une revue bibliographique [Ocular movements and reading: a review]." J Fr Ophtalmol. 2010 Jun;33(6):416-23.
https://pubmed.ncbi.nlm.nih.gov/20570391
Rayner K. "Eye movements in reading and information processing: 20 years of research." Psychol Bull. 1998 Nov;124(3):372-422.
https://pubmed.ncbi.nlm.nih.gov/9849112/
Brown GT, Gaboury I. "The measurement properties and factor structure of the Test of Visual-Perceptual Skills-Revised: implications for occupational therapy assessment and practice." Am J Occup Ther. 2006 Mar-Apr;60(2):182-93
https://pubmed.ncbi.nlm.nih.gov/16596922
Argilés M, Rovira-Gay C, Gantz L, Pérez-Mañá L, Sunyer-Grau B, Gispets J. "The Role of Visual Perception in Reading Across Fonts and Similar Words in Children with Reading Disabilities." Ophthalmic Physiol Opt. 2026 Jul;46(3):560-567
Standford E. Taylor
SUMMARY: Uses of eye movements in terms of reading appraisal.
Leo Angart
SUMMARY: Contains detailed explanations of, and exercises for: amblyopia (or lazy eye), anisometropia (when vision is different between the left and right eye), astigmatism (irregular shaping of the cornea), diplopia (double vision), hyperopia (far-sightedness), myopia (near-sightedness) and strabismus (turning in or out of the eye).
Leo Angart
SUMMARY: This book details strategies designed to improve your eyesight by literally exercising your ability to see, and targets each degree of vision problem.
Borsting E, Mitchell GL, Kulp MT, Scheiman M, Amster DM, Cotter S, Coulter RA, Fecho G, Gallaway MF, Granet D, Hertle R, Rodena J, Yamada T; CITT Study Group.
SUMMARY: A successful or improved outcome after convergence insufficiency treatment was associated with a reduction in the frequency of adverse academic behaviors and parental concern associated with reading and school work as reported by parents.
Danielle F. Leong, OD, Christina L. Master, MD, Leonard V. Messner, OD, Yi Pang, OD, MD, PhD, Craig Smith, MD, Amaal J. Starling, MD
SUMMARY: Saccadic training is vision training that helps improve how accurately and how well your eyes make saccades (the quick eye movements used to jump from word to word while reading). Saccadic training can significantly improve reading fluency.
Lisa W. Christian, Krithika Nandakumar, Patricia K. Hrynchak, Elizabeth L. Irving
SUMMARY: Findings indicate that some children with an identified reading problem also present with abnormal binocular test results compared to published normal values.
Optometry Volume 74/Number 1/January 2003
SUMMARY: Visual factors are significantly better predictors of academic success as measured by the Iowa Test of Basic Skills than is race or socio-economics.
Aparna Raghuram, OD, PhD; Sowjanya Gowrisankaran, PhD; Emily Swanson, BS; David Zurakowski, MS, PhD; David G. Hunter, MD, PhD; Deborah P. Waber, PhD
SUMMARY: Findings suggest that deficits in visual function are far more prevalent in school-aged children with developmental dyslexia than in typically developing readers, but the possible cause and clinical relevance of these deficits are uncertain.
David B. Granet Department of Ophthalmology, Ratner Children’s Eye Center, University of California, San Diego, CA, USA , MD FACS FAAO FAAP, Cintia F. Gomi , MD, Ricardo Ventura , MD & Andrea Miller-Scholte , CO
SUMMARY: The research reports an apparent three-fold greater incidence of ADHD among patients with convergence insufficiency when compared with the incidence of ADHD in the general US population. The research also notes a seeming three-fold greater incidence of convergence insufficiency in the ADHD population.
National Reading Panel, Washington, D. C.: National Academy Press.
SUMMARY: Phenomic awareness can be taught. Phenomic awareness instruction assists children in learning to read. Systematic phonics instruction makes a significant contribution to children's growth in reading. Fluency can be encouraged through instructional procedures. Vocabulary is one of the most important areas within comprehension and should not be neglected. Teachers can be taught to teach reading comprehension strategies effectively.
Armbruster, B.B., Lehr, F., & Osborn, J.
SUMMARY: Things you can do with your child at three different grade levels—kindergarten, first grade, and second and third grades—to help him become a reader, as well as what to look for in quality reading instruction at each grade level.
Cooper, J.D., Chard, D.J., & Kiger, N.D.
SUMMARY: Interventions for struggling readers who need personalized, focused, and assessment-driven instruction in oral language, phonemic awareness, word recognition, vocabulary, fluency, comprehension, and writing.
Snow, C., Burns, M.S., & Griffin, P. (Eds.)
SUMMARY: Reading is most likely to develop easily under conditions of stimulating preschool environments, excellent reading instruction, and the absence of a wide array of risk factors. Includes help for children with reading difficulties in grades 1-3.
LEGAL DISCLAIMER: Eyes Up Reading does not provide clinical diagnosis or prescription from state-licensed optometrists or ophthalmologists or orthoptists. We do not provide optometric vision therapy. We do not treat diagnosed visual disorders, strabismus, or amblyopia. We do not treat dyslexia, ADHD, or learning disabilities. Instead, we provide tutoring/educational intervention and we address visual-skills related to reading, particularly eye-tracking issues that may contribute to reading challenges.
If you need clinical vision therapy, please see a licensed professional.
Testimonials reflect the personal experiences and perspectives of students and families, not medical or optometric diagnoses, treatment claims, or professional medical opinions from Eyes Up Reading. Individual results may vary.
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