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Comment & Response
May 30, 2019

Accurately Assessing Visual Deficits in Children With Developmental Dyslexia—Reply

Author Affiliations
  • 1Department of Ophthalmology, Boston Children’s Hospital, Boston, Massachusetts
  • 2Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
  • 3Division of Psychology, Department of Psychiatry, Boston Children’s Hospital, Boston, Massachusetts
  • 4Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
JAMA Ophthalmol. 2019;137(8):955-956. doi:10.1001/jamaophthalmol.2019.1712

In Reply We thank Elder and Gole for their thoughtful comments on our article.1 Citing Ayton et al,2 they contend that the Developmental Eye Movement (DEM) test is not a valid indicator of saccadic eye movements. The Ayton et al study,2 however, had its own limitations: (1) it included only typical readers (restricting variability and hence correlations); (2) it did not consider normative age-associated changes in eye movements; and (3) it used saccadic measures of gain, latency, and velocity, rather than typical measures associated with reading, such as fixations and regressions. A 2018 study by Moiroud et al3 in children with dyslexia used the DEM to document clear differences in fixation duration in comparison with age-matched and reading-age–matched controls. Furthermore, our DEM findings did not occur in isolation; they correlated moderately with Visagraph eye tracking measures obtained during reading at the participants’ reading level. Thus, we believe it would be premature to dismiss the DEM test as a measure of oculomotor functions associated with reading.