CHANGES IN FORM VISUAL FIELDS IN READING DISABLED CHILDREN PRODUCED BY SYNTONIC (COLORED LIGHT) STIMULATION.

Rocky Kaplan, O.D., M.Ed.

Abstract

Previous clinical reports have suggested that visual field sizes are abnormal in childrenwho areclassifed as reading disabled. The present study measured form and color visual fields for a total of 22 children. Nine of the children read at least two grades or more below their chronological placement and were placed into ar. Experimental Group Four children were placed into Control Group 1. The remaining children, who were handicapped in reading but who were not significantly behind in their reading placement, were placed into a vision therapy program designed to treat General Binocular Dysfunction problems (control group 2). The children in the Experimental Group were exposed to colored lights of specified frequencies, while the 4 children in Control Group I were exposed to plain white light, and the remaining 9 children received only vision therapy for an equivalent duration. Significant form field size changes were measured in the children who received the colored light treatment, while the vision therapy control group had no significant form field size changes. Associated behavioral changes were noted the Experimental group). (In J Biosocial Res..5111.2033.1983.)

INTRODUCTION

Optometric Vision Therapy is concerned with the rernediation of eyeand visua! (brain.eye connection) function that interfere in learning or visual efficiency.

Rosner clearly points out the controversial nature of vision therapy in its relation. ship to learning difficulties. The Ophthalrnological perspective is that persons with lear ning problems do not have serious eye problems. Optornetrists use a perceptual brain/eye moclel when they define vision. Eyesight and vision are not meant to by synonomous. Therein exists the vastly different opinions. Recent research by Hoffman identified a significant higher percentage of eye problems in a clinic population of referred learning disabled children. The eye problems were defined as lack of coordination of the two eyes, focusing ability and oculomotor efficiency. A control population of children demonstrated a lower incidence of the same eye problems.

Seiderman provided vision therapy of perceptual nature to a learning disabled population After nine months of training this group demonstrated significant gains in reading as compared to a control group who received instruction in physical education, art or music. The use of color light in Optometric therapy has been in progress for over fifty years, however is not one of the standard vision therapy procedures. Using specific filters, optometrists have given successfu] treatmen~ to thousands of patients with a great variety of diagnosed problems. Such successful treatment has led practitioners to ask the following types of questions.

Why do optometrists use colored lights? What types of visual problems do they treat? What does light do in the visual system and in the body? Is there scientific evidence that purports that specific light frequencies have an effect on human physiology?

In the 1920's and 30's much interest was generated by Henning in the use of light therapy for the treatment of optometnc problems Light had been used to treat many problems previously such as colds, hay fever, sinusitis, goitre, constipation and other physical ailments. Since these conditions are outside of the scope of optometric practice their treatment by use of light therapy was discouraged by ethical practitioners.

Henning, one of hte pioneers in the use of light therapy, used the term chromeorthoptics to describe the process. Using a classification of color, he prescribed color treatment~for thousands of p~tients. Henning's method was based on the fact that polychromatic light is not focused as a single point of the retina. Since spectral colors are each focused at a different point, according to their wavelengths, the accommodative apparatus of the eye was thought to be influenced by color which was focused on the fovea. By noting that certain prisms and lenses also stimulate or inhibit accommodation, he had a direct correlation between the use of optical devices and the use of light of specific colors. Henning used light therapy, lenses, and standard opthoptic treatment with his patients. He also realized that vision is not a separate physiological entity in the body, but that it is intimately connected to the total person. He believed that chrome.orthoptics treated more than just the symptoms of the visual system; also effected the autonomic nervous system which produced behavioral changes in his patients.

Syntonics in optometry has been used for treatments of such conditions as myopia, strabismus, amblyopia, headaches, visual fatigue, reading problems, and general binocular dysfunctions. Thousands of clinical cases have been presented over the years to show the results of light therapy. Clinically, according to some practitioners, the use of syntonics has been proven an effective form of therapy in the optometric office. But what scientific evidence is there to show that light of certain frequencies effects humans, and what is the method of entry of this light into the body?

SCIENTIFIC DATA

A whole body of knowledge has been developed regarding the effects of light on plants and animals. Wurtman (1975) reported that, along with food, air, and water, sunlight is the most important survival factor for human life. The formation of vitamin D on the skin, control of endocrine Systems, timing of biological clocks, entrainment of ircadian rhythms, immunological responsiveness, sexual growth and development, regulation of stress and fatigue, control of viral infections, and dampening of functional disorders of the nervous system, are all attributable to sunlight. The most important of these to optometrists is the influence of light on the endocrttie system, but does the light energy reach the endocrine system?

Homasaki and Marge (1960) reported on the existence of the posterior accessory optic tract and the anterior accessory optic tract in primates. Some possible functions of these tracts could be to transmit information on light levels to various subthalamic and midbrain centers. Hill and Marge (1963) found, from single cell recordings using monochromatic light, that the accessory optic tract do respond to this stimulation. Luce has reported that light appears to act on the brain in a complex manner, and may influence the rate of maturation on the pineal gland in newborn babies. Light may also trigger the circadian rhythms of adrenal hormones found in the blood, and may influence the neuroendocrine system and thereby modify responses to certain drugs.

It is now generally accepted that light does effect our physiological systems. Many studies have shown the influences of using artificial lighting in schools and industry. Zamkova and Krivitskaya (1966) report that children who studied under full-spectrum lighting had a lower fatigability, significantly improved working capacity, 'and improved academic performance.

SPECIFIC COLORS

What then is the role of specific colors for therapy? It is thought that specific colors (wavelengths) interact with the endocrine system to bring about stimulation or inhibition of hormonal production. Plack and Schick (1974) summarize the effect of color on nonvisual processes in humans. The effects they described included changes in mood, rate of breathing, pulse rate, and blood pressure.

Gerard's (1958) dissertation research is probably the most detailed examination of the differential effects of colored light on psychophysiological functions. His study investigated the effect of different colors on psychophysiological measures indicative of emotional changes. Blue, red, and white lights of equal brightness were each projected for ten minutes on a screen in front of 24 normal adult males. The autonomic nervous system and visual cortex were found to be significantly less aroused during blue than during red or white stimulation. The various colors also elicited significantly different feelings, with blue being associated with increased relaxation, less anxiety, and less hostility, while red illumination was associated with increased tension and excitement. Manifest anxiety levels were significantly correlated with increased physiological activation and subjective disturbance during red stimulation. Conversely, Gerard found responses of quiescence and relief during blue illumination. The work oAaronson (1971) reports much the same effect of specific colors on activation and arousal.

READING PROBLEMS

How then can syntonic light therapy help school age children who have reading problems? It has been suggested in the literature that there is a relationship between visual field size, blind spot size, and the ability of children to read. Brombach (1936) reported on a study involving 158 children classified as poor readers; 109 of the children demonstrated enlarged blind spots. Eighty-three of the children recovered from the enlargement after occlusion of one eye, suggesting a relationship between an enlarged blind spot, and poor reading.

Brombach argued that the incidence of ocular pathology in these types of enlargements was very slight. He felt that the enlarged blindspots reduced the likelihood of full perception and this inhibited accurate and complete reading.

Earnes (1938) studied the relationship of the central vision field to the speed of visual perception. A high correlation was found, and this supported an earlier study of which smaller horizontal and vertical visual fields were found in educationally disadvantaged children. The relationship between visual field size and the ability to be an adequate reader seems obvious from an anatomical perspective. The number of fixations that can be made without an associated head movement will be limited in the case of a significantly reduced visual field.

RESEARCH PROJECT

The data from a number of previous studies, has suggested that form field size will be reduced in poor readers and that the use of syntonic stimulation can rectify the problem. Thus a study was designed to demonstrate this. The study tested two hypotheses:

METHODS

The study was conducted at Pacific University's Optometric Clinic in downtown Portland, Oregon. Children having specific difficulties in reading are referred to this clinical facility by educational, mental health and other settings for routine vision care as well as vision~therapy. For this particular study, a specific educational service district in Multnomah County was contacted to refer children suitable for the experimental group. This meant that the Educational testing on the children was conducted by educators prior to their referral for the project. The children who served in the two controls groups were recruited through newspaper advertisements as well as through the vision therapy clinic of the college. All children in the study were healthy, wore corrective lenses (if prescribed), and were not receiving concurrent therapies. Each participant received a vision screening using the Keystone Telebinocular and a baseline visual field study using a modified monocular stereo campimeter like device. The seline visual field measurement was conducted by a research assistant who had been specifically trained to obtain visual fields with the experimental instrument.

The protocol for the study was to first measure the monocular form field using a whtte 1.0 millimeter target working from nonseeing to seeing. The blindspot was measured from nonseeing to seeing. The right eye form field was measured first followed by the blind spot, then red, blue and green colored fields utilizing the 1.0 millimeter target of the appropriate color. The same test was then repeated on the left eye. The average of the vertical and horizontal measurements are shown in Table 1.

Based on the visual field measurements, the principal investigator randomly assigned the children to the experimental or the white light control group. Neither parents, children or research assistants were told whether the colored light or white light treatments constituted the experimental or the control treatment.

Three of the children had been patients in the Portland Optometric Clinic. Six of the children were referred from the Multnomah Educational Service District, the University of Oregon Medical School, local optometrists, or from the Portland State University Special Educational program. One child was brought in by their parents wtth specific difficulties with handwriting and reading at grade level. In summary, 9 of the subjects in the experimental group were reading at a level at least two years below their chronological placement.

There were an equal number of males and females in the experimental group, (mean age 9 years and 9 months, age range 6 to 16). The four children assigned to the white light control group consisted of three females and one male (mean age 9 years and 4 months, range 6 and 14 years). Ail four were classified as significantly below average in reading ability by the referral agency. Two of the children had esotropia while the other two were diagnosed as having a general binocular dysfunction. Table 2 summarizes the mean horizontal and vertical dimensions of the form and color visual field for the white light control group.

The second control group consisted of ten children with general binocular dysfunction who were randomly selected from the Pacific Vision Therapy Clinic. The results of the visual field measurements for these children are displayed in Table 3. The mean age of the children in the vision therapy control group was 9 years and 7 months with a range from 7 to 13 years. All of the children in this group were found to have experieno ed one or more symptoms associated with inefficient reading, thus the diagnoses were consistent with general binocular dysfunction (lack of coordination between the two eyes). The subjects did not, however, demonstrate significant reading problems such as were found in members of the experimental and the white light control group.