The dual-route system could explain the different rates of dyslexia occurrence between different languages (e.g., the consistency of phonological rules in the Spanish language could account for the fact that Spanish-speaking children show a higher level of performance in non-word reading, when compared to English-speakers). Diagnosis
Dyslexia is a heterogeneous, dimensional learning disorder that impairs accurate and fluent word reading and spelling. Typical—but not universal—features include difficulties with phonological awareness; inefficient and often inaccurate processing of sounds in oral language (phonological processing); and verbal working memory deficits.Dyslexia is a neurodevelopmental disorder, subcategorized in diagnostic guides as a learning disorder with impairment in reading (ICD-11 prefixes "developmental" to "learning disorder"; DSM-5 uses "specific"). Dyslexia is not a problem with intelligence. Emotional problems often arise secondary to learning difficulties. The National Institute of Neurological Disorders and Stroke describes dyslexia as "difficulty with phonological processing (the manipulation of sounds), spelling, and/or rapid visual-verbal responding".The British Dyslexia Association defines dyslexia as "a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling" and is characterized by "difficulties in phonological awareness, verbal memory and verbal processing speed". Phonological awareness enables one to identify, discriminate, remember (working memory), and mentally manipulate the sound structures of language—phonemes, onsite-rime segments, syllables, and words.
Levobunolol (trade names AKBeta, Betagan, Vistagan, among others) is a non-selective beta blocker. It is used topically in the form of eye drops to manage ocular hypertension (high pressure in the eye) and open-angle glaucoma. Contraindications
Like other beta blockers, levobunolol is contraindicated in patients with airway diseases such as asthma and severe chronic obstructive pulmonary disease (COPD), as well as heart problems such as sinus bradycardia, second- or third-degree atrioventricular block, sick sinus syndrome, and cardiogenic shock. Combination with MAO-A inhibitors is also contraindicated because it could cause a dangerous rise in blood pressure.Levobunolol is not useful for the treatment of closed-angle glaucoma. Side effects
The most common side effect is eye irritation felt as stinging or burning, which occurs in up to a third of patients. Blepharoconjunctivitis occurs in up to 5% of patients. Rarer adverse effects include keratitis, edema and increased lacrimation. Allergies are rare, but seem to be more common than under the related drug timolol.If the substance reaches the nasal mucosa via the tear duct, it can be absorbed into the bloodstream and cause systemic side effects. These include orthostatic hypotension (low blood pressure) and other effects on the heart and circulatory system, breathing problems in people with asthma, and skin symptoms such as itching and aggravation of psoriasis. Interactions
Even in the form of eye drops, levebunolol may cause hypotension when combined with alpha blockers, calcium channel blockers, tricyclic antidepressants, and other drugs that lower blood pressure.