VISUAL PROCESSING DISORDERS

Visual Pathways in the Brain

Visual processing disorders involve difficulties understanding visual information such as movement, spatial relationships, form, or direction. Visual processing disorders, together with auditory processing disorders, can disrupt the ability to read, spell, or understand written material.

Spatial relations

The ability to perceive the location of objects in relationship to other objects is a critical skill in reading, math, and handwriting, where a child must be able to recognize the different symbols, perceive their direction, tell the difference between similar shapes, and determine where these are located in relationship to each other. Individuals who have difficulty with spatial relationships may seem unusually clumsy or accident prone, may have difficulty reading or may refuse to read, or may have poor handwriting (dysgraphia).

Visual discrimination

Visual discrimination allows us to tell the difference between similar objects, tell where one object ends and another begins, and to recognize objects and symbols when only part of it can be seen (or when it is fuzzy). Individuals who have visual discrimination disorders often mix up letters or numbers and have difficulty reading or scanning pictures for information.

Visual memory

Visual memory is a critical part of academic skills. It allows us to recognize objects and to remember letters, numbers, symbols, words, and pictures. In cases of partial visual agnosia (visual access problems), what is learned on day one, "forgotten" on day two, may be remembered again without difficulty, on day three.

Visual integration

Some individuals have difficulty perceiving or integrating the relationship between an object or symbol in its entirety and the component parts which make it up. Some children may only perceive the pieces, while others are only able to see the whole. Children with a visual integration disorder will have difficulty learning to read (dyslexia) and recognizing symbols.

Visual pursuit and tracking

The ability to track moving objects while seated or standing, and the ability to keep a stable visual image when the head or eyes are in motion is part of the ocular-vestibular system. Individuals who have visual pursuit disorders have difficulty watching moving objects (e.g. on videos or computer programs), difficulty copying from the board, and difficulty reading.

Alice in Wonderland Syndrome

Alice in Wonderland Syndrome is a visual processing disorder in which the individual experiences distortions in time and space so that objects appear smaller, as if down a tunnel, or time appears to stand still. This disorder is typically the result of a viral infection that has affected the visual pathways in the brain.  While it is disturbing to experience, the symptoms resolve on their own within a short period of time, although there may be several episodes over a series of weeks.   For more information see:

Perez Mendez C, Martin Mardomingo M, Otero Martinez B, Lagunilla Herrero L, Fernandez Zurita C., "Alice in Wonderland syndrome due to Epstein-Barr virus infection]"[Article in Spanish],An Esp Pediatr. 2001 Jun;54(6):601-2.

The Alice in Wonderland syndrome refers to distortions in body image and in the apparent sizes, shapes, and spatial relations of objects seen. The syndrome is usually associated with migraine headaches and has also been reported in several viral infections. We report a 6-year-old boy who presented to the emergency department complaining of several episodes in which the ceiling, the objects and the people around him seemed very small and far away. The child presented no alteration in the level of consciousness. The episodes provoked great fear in the child. Physical examination revealed no abnormalities except pharyngoamygdalitis. Serologic studies (IgM antibodies to viral capsid antigen) confirmed Epstein-Barr virus infection. The child's symptoms resolved spontaneously within 48 hours and he continued to be asymptomatic after a 4 -month follow-up. We consider that all children presenting a clinical picture consistent with the Alice in Wonderland syndrome should undergo serological testing for Epstein Barr virus infection. Diagnosis would enable physicians to reassure the family of the temporary and benign nature of this alarming condition.

More information about visual processing disorders and their treatments can be found in

Sensory Processing Disorders or at VisionTherapy.org

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