When Swedish students struggle with reading, it's not always the letters or words that are the problem – sometimes it's their vision itself that isn't cooperating. During Skolporten's conference Reading and Writing Difficulties 2025, Professor Rune Brautaset delivered a comprehensive lecture on visual processing and its crucial role in reading and learning.
Rune Brautaset is a professor of optometry and co-founder of Imvi Labs. His 57-minute lecture, now available on YouTube, provides valuable insights for teachers, special educators, and anyone working with students with reading and writing difficulties.
Vision begins in the brain, not the eye
Rune begins the lecture by clarifying his involvement in the development of Imvi Labs and emphasizes a fundamental truth: "The eye functions like a camera and the brain interprets what we see."
The discussion shows that vision involves recognizing and comparing new information with previously stored visual memories, demonstrated by how the brain interprets an inverted image on the retina.
The concept of visual attention is illustrated with an image containing hidden faces, demonstrating how prior knowledge and recognition affect what we perceive and filter out.
Common vision problems: From nearsightedness to astigmatism
Rune explains the most common vision problems:
Normal vision and refractive errors
- Normal vision (emmetropia): Light focuses perfectly on the retina
- Nearsightedness (myopia): Light focuses too early, in front of the retina
- Farsightedness (hyperopia): Light focuses behind the retina
- Astigmatism (refractive error): The eye is shaped like an American football, causing light to focus on two different points, leading to a stretched appearance of objects
Normal vision is typically referred to as 1.0, with 0.5 being the legal limit for driving.
How children's vision develops – from almost blind to full visual acuity
A fascinating part of the lecture is about how children's vision develops:
- Newborns: Very poor vision, around 0.02 – which is legally blind for an adult
- First 6 months: Vision improves rapidly
- Age 5: The child reaches almost full visual acuity
- School start: Most children achieve full vision, although understanding what they see can still be a challenge
Children's vision improves rapidly during the first six months and reaches almost full visual acuity by age five, but full visual comprehension, or understanding what is seen, develops later.
When visual acuity decreases, details in the image are lost, while the overall image in the periphery often remains intact.
Emmetropization: The eye's natural growth
Most children are born farsighted, but through a process called emmetropization, their eyes grow and correct this refractive error around six years of age.
Brautaset highlights Sweden's unique advantage: "Unlike some Asian countries where severe nearsightedness is a public health problem, Sweden's outdoor culture and school breaks help prevent a similar 'myopia pandemic' by providing varied light exposure."
Age-related vision changes
The eye's lens hardens with age, losing its elasticity and ability to adjust focus, similar to how a fingernail grows but cannot be cut, causing cells to pack more densely.
This hardening can lead to cataracts, the most common operation in Sweden with 130,000–150,000 operations annually, where the lens is replaced with a plastic lens.
The age-related inability to focus at different distances is called presbyopia or age-related farsightedness, which often leads to the need for reading glasses.
Some children also struggle to maintain focus, including those without other diagnoses and those with conditions such as brain injuries, making reading challenging.
The development of binocular vision in infants
Infants initially cannot make independent eye movements or focus, but these abilities develop rapidly within the first few months, enabling binocular vision at four to six months of age.
Binocular vision, where both eyes focus on the same object, allows for the development of 3D perception, enabling us to experience depth due to the slightly different angles perceived by each eye.
Benefits of binocular vision
In addition to depth perception, binocular vision offers advantages such as:
- A wider field of vision
- The brain's ability to combine two images for improved visual acuity
The brain constantly filters out double images of objects not directly focused on, a phenomenon demonstrated by the 'flying sausage' illusion and the perception of double fingers when looking past an object.
The two categories of vision problems
Rune categorizes common vision problems into two main groups: problems with eye alignment and focusing.
1. Eye alignment problems
Latent strabismus (phoria):
- Individuals struggle to fuse images
- Can be demonstrated by covering one eye and observing its drift
- Approximately 10% of schoolchildren struggle to compensate for latent strabismus
- Leads to symptoms such as headaches and double vision, especially during close work
2. Focusing problems
Accommodative insufficiency (insufficient accommodation):
- Difficulty adjusting focus
- Affects approximately 10% of children and adolescents
- Often in combination with eye movement problems
- Individuals experience blurry vision when reading, making it challenging to learn or read for learning
Modern lifestyle exacerbates vision problems
A key observation from Rune Brautaset: "While the genetic prevalence of these problems may not have increased, modern lifestyles with extensive screen time have moved activities indoors, exacerbating these problems for many."
Many people experience problems such as double vision due to increased close-up activities, which is not necessarily genetic.
Double vision: A hidden and overlooked problem
"Reading with partial double vision is very challenging and makes it difficult to understand text, often leading to slow reading and frustration."
The big problem is that many individuals, especially children, may not realize they have double vision because they are accustomed to their unique visual experience.
Traditional vision training: Old knowledge that works
Treatments for latent strabismus or phoria have been well-documented since the mid-1800s, involving simple eye exercises.
These exercises, though tedious, are effective, especially when performed consistently for 20-30 minutes daily, as shown by American studies.
While adherence to home exercises is often low, those who consistently perform them achieve excellent and lasting results.
Modern digital solutions: VR changes everything
Digital environments have transformed these exercises, allowing users to train for longer periods, such as watching an entire movie, significantly improving engagement and results.
Modern training methods, such as using a mobile phone in VR glasses, present two moving images to train eye movements and the brain's ability.
This training simultaneously improves:
- Eye movements to minimize double vision
- The brain's capacity to filter out remaining double images
This makes the training more engaging than traditional exercises.
Challenges with visual processing and attention
The discussion highlights difficulties with eye movements and focusing, along with challenges in reading situations, especially for individuals with ADHD who struggle to select relevant information, leading to information overload.
For individuals with dyslexia, studies from England indicate specific difficulties in reading situations, emphasizing the importance of attention to filter out irrelevant information while focusing on essential visual data.
When reading, the ability to follow a line, decode letters, and move to the next line is crucial, and if the image is double or blurry, it becomes difficult to concentrate visually.
Which groups are affected?
Several groups experience these visual concentration problems:
- Those with binocular vision problems (10-20%)
- Individuals with dyslexia and ADHD
- Older adults with stroke or brain injuries
- Those with post-COVID
All of these can benefit from similar training to improve eye control and filtering.
Dyslexia and binocular vision: New research
Research suggests that individuals with dyslexia may experience more problems with binocular vision, particularly with focus, even if clinical tests for eye movements do not always show this.
The English study
English researchers found that children with dyslexia change their eye movement behavior specifically during reading, leading to a slightly double image that the brain constantly struggles to filter.
Training children with dyslexia using a system based on similar principles significantly improved their reading speed and comprehension compared to a control group.
The training showed positive results for many, even those who were already good readers, emphasizing the need to address children's vision and binocular alignment in addition to other support.
Questions from the audience:
Rune Brautaset answers several important questions from the audience:
Can a regular eye exam detect these problems?
A regular eye exam can detect focusing problems, but specific eye movement patterns in children with, for example, dyslexia require a special investigation.
Glasses or training?
Glasses correct refractive errors and can sometimes correct eye misalignment with prisms, but this is a passive solution compared to eye coordination training.
Binocular vision problems do not necessarily mean that a child has another visual impairment or needs glasses, especially in cases of latent misalignments.
How long do the training results last?
Imvi's training is lasting as long as the person has trained according to the training plan. To achieve lasting results, one should train for as long AGAIN as it took to become symptom-free. For example, if you became symptom-free in week 6, you should train for a total of 12 weeks to get lasting results. Later in life, other factors can affect your vision, such as age-related vision problems - then you may need to train again.
The problem with school vision screenings
Current school vision screenings primarily test visual acuity and may miss binocular vision problems, so it is important to look for symptoms such as headaches or difficulty reading for extended periods.
What teachers should observe
Teachers should be aware that approximately 10% of students may have difficulty with eye alignment and another 10% with focus adjustment, which often manifests as:
- Avoidance of reading
- Closing one eye
- Unusual head postures
Even more importantly, a full 80% of children with reading and writing difficulties have pre-clinical binocular vision problems, something this American study highlights.
Skolporten's conference: An important meeting place
Skolporten's conference Reading and Writing Difficulties 2025 gathered teachers, special educators, and researchers from across Sweden to discuss the latest research and best practices in the field.
Rune Brautaset's lecture was one of many valuable presentations that shed light on various aspects of reading and writing difficulties from neurological, pedagogical, and technological perspectives.
Three important insights from the lecture
1. Vision problems affect more people than we think
10-20% of schoolchildren have binocular vision problems that can affect reading – many without knowing it & a full 80% of those with reading and writing difficulties have pre-clinical binocular vision problems.
2. School vision tests are not enough
Standard eye examinations primarily test visual acuity and often miss binocular problems such as latent strabismus and accommodative insufficiency.
3. Vision check before dyslexia assessment
Good vision can significantly help individuals manage their dyslexia, therefore vision checks should precede dyslexia assessments.
Watch the full lecture
The complete 57-minute lecture is available on YouTube and provides a deeper understanding of:
- Eye physiology and the development of vision
- Detailed review of various vision problems
- Binocular vision and 3D perception
- Demonstrations and visual illusions
- The connection between dyslexia, ADHD and vision problems
- Modern training methods with VR
- Questions and answers from conference participants
📺 Watch the video here: https://www.youtube.com/watch?v=WHxwukifmEk
The lecture is particularly valuable for:
- Teachers in primary and secondary schools
- Special education teachers and special needs educators
- School nurses and school healthcare
- Parents of children with reading challenges
- Opticians and optometrists working with children
Want to know more?
For teachers and special needs educators:
- Monitor symptoms of vision problems in the classroom
- Contact us at Imvi Labs to learn more about the training, how it works in a classroom & statistics from the schools we work with.
For parents:
- Be aware of signs such as avoiding reading or unusual head positions during close work
- See reviews from parents whose children have trained with Imvi
Summary
Rune Brautaset's lecture at Skolporten's conference provides us with important insights into an often overlooked area in reading and writing difficulties. By understanding that vision is more than just visual acuity, and that binocular problems affect 10-20% of schoolchildren and 80% of those with reading and writing difficulties, we can help more students reach their full potential.
The lecture clearly shows that:
- The brain interprets what we see - not just the eye
- Many children have binocular vision problems without knowing it
- Traditional eye exercises work, but are boring
- Modern VR solutions make training engaging and effective
As Brautaset reminds us: "Good vision can significantly help individuals with reading."
