There’s no question that good vision is important for learning. Experts say more than 80% of what your child is taught in school is presented to them visually.
To make sure your child has the visual skills they need for school, the first step is to make sure your child has 20/20 eyesight and that any nearsightedness, farsightedness and/or astigmatism is fully corrected with glasses or contact lenses. But there are other, less obvious learning-related vision problems you should know about as well.
Good Vision Is More Than 20/20 Visual Acuity
Your child can have “20/20” eyesight and still have vision problems that can affect their learning and classroom performance. Visual acuity (how well your child can see letters on a wall chart) is just one aspect of good vision, and it’s not even the most important one. Many nearsighted kids may have trouble seeing the board in class, but they read exceptionally well and excel in school.
Other important visual skills needed for learning include:
- Eye movement skills – How smoothly and accurately your child can move their eyes across a printed page in a textbook.
- Eye focusing abilities – How well your child can change focus from far to near and back again (for copying information from the board, for example).
- Eye teaming skills – How well your child’s eyes work together as a synchronized team (to converge for proper eye alignment for reading, for example).
- Binocular vision skills – How well your child’s eyes can blend visual images from both eyes into a single, three-dimensional image.
- Visual perceptual skills – How well your child can identify and understand what he sees, judge its importance, and associate it with previous visual information stored in his brain.
- Visual-motor integration – The quality of your child’s eye-hand coordination, which is important not only for sports, but also for legible handwriting and the ability to efficiently copy written information from a book or chalkboard.
Deficiencies in any of these areas can significantly affect your child’s learning ability and school performance.
Many Kids Have Vision Problems That Affect Learning
Many kids have undetected learning-related vision problems. In fact, children are often misdiagnosed with learning problems or ADD/ADHD when, in fact, they have a vision problem.
According to the College of Optometrists in Vision Development (COVD), one study indicates 13% of children between the ages of 9 and 13 suffer from moderate to severe convergence insufficiency (an eye teaming problem that can affect reading performance), and as many as one in four school-age children may have at least one learning-related vision problem.
Signs and Symptoms of Learning-Related Vision Problems
There are many signs and symptoms of learning-related vision disorders, including:
- Blurred distance or near vision, particularly after reading or other close work
- Frequent headaches or eye strain
- Difficulty changing focus from distance to near and back
- Double vision, especially during or after reading
- Avoidance of reading
- Easily distracted when reading
- Poor reading comprehension
- Loss of place, repetition, and/or omission of words while reading
- Letter and word reversals
- Poor handwriting
- Hyperactivity or impulsiveness during class
- Poor overall school performance
If your child exhibits one or more of these signs or symptoms and is having problems in school, call us to schedule a comprehensive children’s vision exam.
Comprehensive Children’s Vision Exam
A comprehensive children’s vision exam includes tests performed in a routine eye exam, plus additional tests to detect learning-related vision problems. These extra tests may include an assessment of eye focusing, eye teaming, and eye movement abilities (also called accommodation, binocular vision, and ocular motility testing). Also, depending on the type of problems your child is having, we may recommend other testing, either in our office or with a children’s vision and/or vision development specialist.
If it turns out your child has a learning-related vision problem that cannot be corrected with regular glasses or contact lenses, then special reading glasses or vision therapy may help. Vision therapy is a program of eye exercises and other activities specifically tailored for each patient to improve vision skills.
Vision and Learning Disabilities
A child who is struggling in school could have a learning-related vision problem, a learning disability or both. Vision therapy is a treatment for vision problems; it does not correct a learning disability. However, children with learning disabilities may also have vision problems that are contributing to their difficulties in the classroom.
Article ©2015 Access Media Group LLC. All rights reserved.
Eye Exams for Children
As a parent, you may wonder whether your pre-schooler has a vision problem or when a first eye exam should be scheduled.
Eye exams for children are extremely important. Experts say 5% to 10% of pre-schoolers and 25% of school-aged children have vision problems. Early identification of a child’s vision problem is crucial because, if left untreated, some childhood vision problems can cause permanent vision loss.
When Should Kids Have Their Eyes Examined?
According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. Children then should receive additional eye exams at 3 years of age, and just before they enter kindergarten or the first grade at about age 5 or 6.
For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually or according to their eye doctor’s recommendations.
Early eye exams also are important because children need the following basic visual skills for learning:
- Near vision
- Distance vision
- Eye teaming (binocularity) skills
- Eye movement skills
- Focusing skills
- Peripheral awareness
- Eye/hand coordination
Because of the importance of good vision for learning, some states require an eye exam for all children entering school for the first time.
Scheduling Your Child’s Eye Exam
Your family doctor or pediatrician likely will be the first medical professional to examine your child’s eyes. If eye problems are suspected during routine physical examinations, a referral might be made to an ophthalmologist or optometrist for further evaluation. Eye doctors have specific equipment and training to help them detect and diagnose potential vision problems.
When scheduling an eye exam, choose a time when your child is usually alert and happy. Specifics of how eye exams are conducted depend on your child’s age, but an exam generally will involve a case history, vision testing, determination of whether eyeglasses are needed, testing of eye alignment, an eye health examination and a consultation with you regarding the findings.
After you’ve made the appointment, you may be sent a case history form by mail, or you may be given one when you check in at the doctor’s office. The case history form will ask about your child’s birth history (also called perinatal history), such as birth weight and whether the child was full-term. Your eye doctor also may ask whether complications occurred during the pregnancy or delivery. The form will also inquire about your child’s medical history, including current medications and past or present allergies.
Be sure to tell your eye doctor if your child has a history of prematurity, has delayed motor development, engages in frequent eye rubbing, blinks excessively, fails to maintain eye contact, cannot seem to maintain a gaze (fixation) while looking at objects, has poor eye tracking skills or has failed a pediatrician or pre-school vision screening.
Your eye doctor will also want to know about previous ocular diagnoses and treatments involving your child, such as possible surgeries and glasses or contact lens wear. Be sure you inform your eye doctor if there is a family history of eye problems requiring vision correction, such as nearsightedness or farsightedness, misaligned eyes (strabismus) or amblyopia (“lazy eye”).
Eye Testing for Infants
It takes some time for a baby’s vision skills to develop. To assess whether your infant’s eyes are developing normally, your eye doctor may use one or more of the following tests:
- Tests of pupil responses evaluate whether the eye’s pupil opens and closes properly in the presence or absence of light.
- “Fixate and follow” testing determines whether your baby can fixate on an object (such as a light) and follow it as it moves. Infants should be able to perform this task quite well by the time they are 3 months old.
- Preferential looking involves using cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes. In this way, vision capabilities can be assessed.
Eye Testing for Pre-School Children
Pre-school children can have their eyes thoroughly tested even if they don’t yet know the alphabet or are too young or too shy to answer the doctor’s questions. Some common eye tests used specifically for young children include:
- LEA symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
- Retinoscopy is a test that involves shining a light into the eye to observe how it reflects from the retina (the light-sensitive inner lining of the back of the eye). This test helps eye doctors determine the child’s eyeglass prescription.
- Random dot stereopsis uses dot patterns to determine how well the two eyes work as a team.
Eye and Vision Problems that Affect Children
Besides looking for nearsightedness, farsightedness and astigmatism (refractive errors), your eye doctor will examine your child’s eyes for signs of the following eye and vision problems commonly found in young children:
- Amblyopia. Also called “lazy eye,” this is decreased vision in one or both eyes despite the absence of any eye health problem or damage. Common causes of amblyopia include strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia may include patching the dominant eye to strengthen the weaker eye.
- Strabismus. This is misalignment of the eyes, often caused by a congenital defect in the positioning or strength of muscles that are attached to the eye and control eye positioning and movement. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on its cause and severity, surgery may be required to treat strabismus.
- Convergence insufficiency. This is the inability to keep the eye comfortably aligned for reading and other near tasks. Convergence insufficiency can often be treated successfully with vision therapy, a specific program of eye exercises.
- Focusing problems. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again (accommodative infacility) or have problems maintaining adequate focus for reading (accommodative insufficiency). These problems often can be successfully treated with vision therapy.
- Eye teaming problems. Many eye teaming (binocularity) problems are more subtle than strabismus. Deficiencies in eye teaming skills can cause problems with depth perception and coordination.
Vision and Learning
Experts say that 80% of what your child learns in school is presented visually. Undetected vision problems can put them at a significant disadvantage. Be sure to schedule a complete eye exam for your child prior to the start of school.
Article ©2015 Access Media Group LLC. All rights reserved. Reproduction other than for one-time personal use is strictly prohibited.