Published: 13 January 2021 | Updated: 28 September 2026 | Author: Smart Vision Optometry
Editorial and clinical update — 28 September 2026: The original article/interview body below is retained in its editorial form, including its attributed quotations and narrative structure. Current evidence and clinical guidance are presented separately below and should be relied on where older wording or claims differ.
Putting the right shoe on the right foot, standing up straight, keeping within the lines when writing, and recognizing the shapes of objects and how far apart they are, may all seem to be natural and automatic responses for those with good perceptual vision and well developed visual-spatial skills. But for those without either of them, there is nothing simple or automatic about doing these seemly simple tasks, or about trying to understand the space they are in and determining their relationship to the world around them, according to Australian behavioural optometrist and founder of Smart Vision Optometry, Gary Rodney.
Turning Lives and Function Upside Down
Brought about by a glitch in the visual processing system, spatial relation problems can quite literally turn children’s lives around, upside down, and back to front; as well as leading to a number of actions and responses which might be labelled mistakenly as bad behaviour; physical and social clumsiness; or learning difficulties (especially when it comes to maths, reading, and writing).
Rodney says spatial relationship problems can affect the way children stand, how they walk, dance, or play; as well as their ability to concentrate, solve problems, recognise shapes, and make sense of numbers and letters.
“Children who haven’t fully developed their vision-spatial relationship skills have a lot in common with those who try to identify, place and join together the pieces of a puzzle game. If placed together correctly, the puzzle pieces would provide a beautiful picture. If it’s never finished, and instead is left partly completed on the table, the resultant picture will continue to be confusing, disorientating, and isolating for as long as it lies there.
For those with vision-spatial relation difficulties, the table is the world, the unfinished picture is their place in that world, and the missing pieces represent their lack of understanding of where they and objects around them fit into the picture, how close they are together, and what shape they are. And this creates more and longer-lasting confusion together with a feeling of being isolated from the world around them,” Rodney says.
A Glitch in the Toolbox
According to Rodney, deficiency in visual-spatial relations is not really a vision dysfunction, but rather a missing gap in the toolbox of vision skills which ensure that all the necessary data the brain needs to process the information is sent to it by the eyes.
The brain, more than half of which is devoted to processing information, relies on its “libraries” of previously processed data to confirm or challenge the accuracy of new messages from the eyes. Special attention is paid to the construction, colour, location and environment involved, so as to give the finished image a meaning that’s relevant and understandable.
However, Rodney says that is precisely the sort of information those with visual-spatial and perceptive vision problems are unable to provide. This is because of their inability to understand shapes and their differences; locations and movement-based activities; the distance between objects, and directions like up and down, as well as left and right. And because of that, neither can they understand how to organize groups of objects, words, letters or numbers in a synchronized way, any more than they can “organize” their physical or mental relationship with them.
For more information on visual skills and their importance, and their therapy, visit the Smart Vision website: Optometrists Sydney: Optometry Services For Children and Adults | Smart Vision; for specific information about Myopia treatment and prevention visit Myopia Prevention: Solutions, Control And Treatment In Sydney; and for detailed information about Myopia Treatment visit Orthokeratology In Sydney: The Non Surgical Alternative.
Book an appointment for a thorough eye check-up or Call the Bondi clinic on (02) 9365 5047 or the Mosman clinic on (02) 9969 1600.
Current evidence and clinical context
Depth perception concerns how near or far things appear. Stereopsis is one part of it, using the slightly different views from the two eyes. There are also depth cues available with one eye. The Webvision chapter on depth perception explains this distinction.
No. A child who drops objects, finds ball games difficult or struggles with handwriting may need support, but those observations do not identify the cause. The NHS guidance on developmental coordination disorder also cautions that appearing clumsy alone does not establish that diagnosis.
For broader coordination or developmental difficulties, start with the child’s GP. Depending on the concern, assessment may involve a paediatrician, occupational therapist, physiotherapist or psychologist. The NHS description of coordination assessment shows why medical history, age-appropriate motor testing and everyday impact matter. An eye examination is one possible part of that broader process.
Related reading
guide to the eyes and brain; functional-vision guide; dyslexia and vision guide.
Frequently asked questions
Do difficulties with handwriting prove that a child has an eye problem?
No. Handwriting involves several skills. Visual symptoms can be assessed alongside broader motor, developmental and educational concerns.
Is depth perception the same as every visual-spatial skill?
No. Judging depth is one aspect of using visual information. It does not describe every skill involved in organising a page, moving or learning.
Should a child’s support wait until every assessment is complete?
Discuss suitable support with the school and relevant professionals while assessment proceeds. Keep goals specific and review what helps.
Discuss visual concerns locally
Contact the Bondi Beach practice or Mosman practice to discuss eye symptoms and an appropriate appointment. Broader developmental concerns should also be discussed with the child’s GP.
