A BSTRACT Oculomotor dysfunction, accommodative issues, convergence insufficiency, and impaired visual information processing are classifications of common visual performance deficits in children and adolescents with attention-deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder. These common deficits impact visual comfort, scholastic performance, and attention. Students possessing behaviors consistent with ADHD have new methods of therapy that are considered non-pharmacological, which can be used to improve visual function and cognition, such as cognitive behavioral therapy (CBT) and vision therapy (VT). The purpose of this meta-analysis is to determine the effectiveness of vision therapy (VB) and CBT for improving visual function in those with ADHD. A comprehensive literature review was conducted using PubMed, Web of Science, Scopus, and Google Scholar, commencing in March 2025. A total of ten papers were selected for this review based on visual outcomes and construction methodology consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 provisions. The studies included nine randomized controlled trials (RCTs) and one case-control study. We applied Standardized Mean Difference Effect Size (Hedges’ g) to conduct meta-analytic calculations for data obtained from oculomotor control tests, binocular vision, contrast sensitivity, and visual attention. While CBT produced moderate effects on executive functioning ( g = 0.36), VT had a more substantial effect on visual abilities ( g = 0.48), and the pooled total effect was moderate at g = 0.42. The greatest effect size ( g = 0.45) was rare in the VT+CBT condition. There was moderate heterogeneity in the studies (I² = 34.6), and subgroup analyses revealed differences by age and methodological rigor. Egger’s test’s P value of 0.041 suggests the presence of publication bias. Overall, to enhance visual and cognitive functioning in students with ADHD, these findings support a multimodal therapy strategy with both VT and CBT. These findings should be further tested and built upon, with larger, more rigorous samples and approaches.
Mahak et al. (Wed,) studied this question.