American Family Vision Clinic Logo
Wilmer, Jeremy B.*; Buchanan, Gregory M.

Nearpoint Phorias After Nearwork Predict ADHD Symptoms in College Students

publication date
March 4, 2009
see more



Phorometric findings have been observed to change with stress. We test the hypothesis that postnearwork phorias predict symptoms that have been theorized to result from nearwork-induced visual stress.



We measured nearpoint and farpoint dissociated phorias in 37 unselected college students with an alternate cover test both before and after a challenging reading comprehension test. We also assessed a broad range of putative attention deficit hyperactivity disorder (ADHD)-related symptoms with the Nadeau College-level ADHD Questionnaire.



For phorias measured at nearpoint after nearwork, greater deviation from the median phoria (three exophoria) predicted higher symptoms (ρ (35) = 0.52, p < 0.001), whether that deviation was in a convergent or a divergent direction (both ρ's (18) = >0.48, p's < 0.04). An analogous result was obtained for “distance-near” stimulus accommodative convergence to accommodation (AC/A) ratios calculated from phorias, where greater deviation from median postnearwork AC/A ratio predicted higher symptoms (ρ (35) = 0.52, p < 0.0001). Symptoms did not correlate with prenearwork phorias, prenearwork AC/A ratios, or postnearwork farpoint phorias (p's > 0.05).



Phorias postnearwork, but not prenearwork, predicted self-reported ADHD-related symptoms in college students. These results link binocular imbalance immediately after sustained nearwork to symptoms theorized to result from nearwork-induced visual stress.


Such a nice optician. My grandson is only 4 and needs glasses. We were so sad, but he explained the issues, and we will follow up as he suggested.

Anna P.

I had such a good experience with the clinic. Very friendly staff and doctor, did not have to wait for long to be called, and was treated respectfully. Thanks, American Family.

June S.

Dr. Zurcher has gone above and beyond what any other eye doctor has ever done to figure out what is going on with my eyes. Very happy with American Family Vision.

Christine R.

Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.

Lars Wulff

Very professional, yet kind and helpful. They do what they can to make the appointment comfortable. I was running a bit late, I made sure ti call. They were able to switch me with a patient who was already there, they treated me with respect, and helped my son have confidence by getting him the eye care he needed that day. Thank you so much! Would recommend to anyone. It's a blessing that they care enough to work with people who have all different types of insurance from work to state coverage.

Justin E.

The staff is friendly. The Doc is very knowledgeable. The office is family friendly and everyone is so patient with the little ones.

Amy Fagerness
1 2 3



Discover effective treatment options for diabetic retinopathy; consult our eye care professionals to protect your vision and overall well-being

Treating diabetic retinopathy Treating diabetic retinopathy is a critical aspect of preserving vision and maintaining the overall quality of life […]

Read More
Carrots for eyes

Are Carrots Good for Your Eyes?

As an optometrist at American Family Vision Clinic in Olympia, one of the most common questions Dr. Levi Zurcher often […]

Read More

Understanding Foggy vision

Is foggy vision troubling you? Let our experienced optometrist restore your sight – book an appointment today and see the […]

Read More
see all blogs

Contact Us To Amplify Your EyeCare

Working Hours

Monday - Thursday
8:00 am - 5:15pm
400 Yauger Way SW. Bldg 1, Ste A Olympia, WA 98502
Website Accessibility Policy
Safety protocols page
phone-handsetarrow-uparrow-right linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram