What are the signs and symptoms that might indicate a child has a vision problem?

1. Could your child have 20/20 vision and still have a vision problem?

When people are asked "what is the definition of good vision", the most common responses are:

"Good vision is...

• the ability to see the small letters on a chart".
• seeing 20/20 on the vision chart at school or at the pediatrician".

Although there is some validity to these responses, good vision actually encompasses much more. Optometry believes good vision actually consists of three components, which are:

• The ability to see small detail (clarity)
• The ability to read or use the eyes for long periods of time without fatigue (comfort)
• The ability to analyze and interpret visual input (processing skills)

2. What problems can cause difficulties with clarity and these important for school performance?

Conditions such as nearsightedness (myopia), farsightedness (hyperopia) and astigmatism can cause blurry vision. These conditions are usually easily treated with eyeglasses, which results in a restoration of clear vision. Having 20/20 vision is important. However, seeing clearly does not guarantee comfortable vision.  There are many individuals who see very clearly yet find it difficult to read or concentrate for more than several minutes.

3. What problems can cause a child to have uncomfortable vision?

Many children can see clearly and may still have significant vision problems.  When they are tested at school as part of the school vision screening, they pass.  These children have vision problems which interfere with their ability to see comfortably.

Conditions such as eye teaming, eye focusing and tracking problems can cause discomfort associated with reading. If a child has difficulty controlling the coordination of his eyes, is unable to maintain focus or has difficulty aiming his eyes and scanning along a line of print, he/she may use extra effort to overcome these problems, leading to discomfort.

4. What are the most common symptoms of eye teaming, focusing and tracking problems?

• Child complains of eyestrain and headaches
• Child complains of words moving on the page
• Tired at the end of the day
• Loses place often
• Must use finger or guide to keep place
• Skips lines and words often
• Poor reading comprehension
• Short attention span

5. What do you mean by a visual perceptual or visual processing problem?

The ability to analyze and interpret visual input is sometimes referred to as visual processing or visual perceptual skills. Optometrists believe this is an important aspect of vision, particularly for children in elementary school. Just because a child can see clearly and comfortably does not guarantee he/she will be able to make comprehend the incoming information.

These skills are important when a child is young and is learning letter and number recognition, reading and early math skills. In some children, the development of visual perceptual skills does not keep pace with the child's growth in other areas. This type of lag can lead to difficulty.

6. What are the signs of Visual Processing Problems?

• Reverses letters and numbers
• Poor reading comprehension
• Poor recall of visually presented material
• Trouble with spelling and sight vocabulary
• Sloppy writing skills, erases excessively
• Trouble copying from board to book
• Can respond orally but not in writing
• Seems to know material but does poorly on written tests

7. How can you find out if your child is at risk for a learning related vision problem?

If your child has any of the symptoms or behaviors listed above, he/she should have a full optometric vision evaluation designed to detect learning related vision problems. This examination goes way beyond the typical eye exam and looks for problems with clarity, comfort and processing. The Pediatric Department of The Eye Institute have doctors with advanced training, knowledgeable of working with children with learning related vision problems. 

8. What can be done if my child has a learning related vision disorder?

The doctors at the Pediatric Department of The Eye Institute will work along with the child’s school and teachers to rule out other possible problems. Once it is determined that the vision problem is important, a therapy program will be developed which may include glasses, office visits and computer-based home therapy.

9. What is Vision Therapy?

Vision therapy is an individualized treatment program prescribed to eliminate or improve conditions such as lazy eye (amblyopia), focusing, eye teaming and learning related vision disorders. Special lenses, prisms, filters and instruments are used along with other specialized instruments and an advanced computer system.

10. Is there evidence that Vision Therapy works?

There is research supporting the effectiveness of vision therapy for treatment of eye teaming, focusing, tracking and visual processing problems. In recent years, several randomized clinical trials have definitively demonstrated the effectiveness of vision therapy. The doctors at The Eye Institute have been directly involved in this research and can apply this new knowledge to help your child.

05/2008