Teachers know that good vision is essential for children being fit, healthy and ready to learn.1 Unfortunately, two in five children have vision conditions that affect learning.2
According the the American Optometric Association'S (AOA) Health Policy Institute, "In the U.S. one in every four children has a vision disorder that requires diagnosis and treatment by an eye doctor, yet 93% of children during the critical developmental years before starting school never see an eye doctor for diagnosis and treatment. This situation exists because of a singular overreliance on so-called “vision screening” to identify children requiring eye examination from an eye doctor."4
For this reason, the AOA recommends that all children have a comprehensive eye exam by an eye doctor, as opposed to a vision screening, before beginning first grade. Children beyond first grade who have not yet had an eye exam by an eye doctor should be referred for an eye exam regardless of vision screening status.
Undiagnosed and untreated vision disorders increase the potential for misdiagnosis of special needs and Attention Deficit Hyperactivity Disorder (ADHD), placing unnecessary stress on families and classrooms.5
Vision disorders are often "silent," with no outward symptoms. Parents are unaware that their child needs an eye exam. Left untreated, vision conditions may cause irreparable harm.
Fortunately, the U.S. Congress and federal agency officials have made children's vision care a true national health care priority. Now, under federal law and regulations, pediatric eye health is recognized as essential medical care. Millions of previously uninsured children now have insurance coverage for annual eye exams and follow-up care.6 As the starting point for primary prevention, children's eye exams can help assure children a lifetime of vision health and learning.
Schools and teachers can also help by moving away from relying on vision screenings to assuring all children receive eye examinations from an eye doctor.
When children have trouble reading, parents and teachers need to investigate many possible causes. That's because reading difficulty usually stems from a combination of problems, rather than just one.
One potential problem that is sometimes overlooked is the child's vision. This may happen because the child appears to be able to see, does not complain about his or her eyes or has passed a school vision screening.
Reading requires the integration of a number of vision skills: visual acuity, visual fixation, accommodation, binocular fusion, saccades, convergence, field of vision, and form perception. The typical school eye chart test only evaluates the visual acuity far away. And parents, teachers or children often don't notice the symptoms of reading-related vision problems.
A comprehensive optometric examination, however, covers all of these vision skills. Any child who is having trouble reading should have a comprehensive eye exam. Following are the vision skills that a doctor of optometry will evaluate during the exam:
During a comprehensive eye examination, the doctor of optometry examines these vision skills and determines how well the child is using them together. If your doctor of optometry diagnoses a vision problem, he or she can prescribe glasses, vision therapy, or both.
Vision therapy can be very effective in treating reading-related vision problems. Your doctor of optometry designs an individualized program of training procedures to help your child acquire or sharpen the vision skills necessary for reading.
Because reading problems usually have multiple causes, treatment must often be multidisciplinary. Educators, psychologists, doctors of optometry and other professionals must work together to meet each child's needs.
The doctor of optometry's role is to help the child overcome the vision problems interfering with the ability to read. Once this is accomplished, the child is then more capable of responding to special education efforts aimed at treating the reading problem itself.
Share this handout with your students to enhance their understanding of their eyes and vision.
Please feel free to reference and repoduce any classroom exercises for your use.
In addition to the children's resources available for purches at the AOA Marketplace, we invite you to download and reproduce any of the free activity sheets for your use.
1. ASSOCIATION BETWEEN READING SPEED, CYCLOPLEGIC REFRACTIVE ERROR, AND OCULOMOTOR FUNCTION IN READING DISABLED CHILDREN VERSUS CONTROLS, PATRICK QUAID AND TREFFORD SIMPSON, GRAEFES ARCH CLIN OPHTHALMOLOGY (2013) 251:169-87.
2. NATIONAL INSTITUTES OF HEALTH THE MULTI-ETHNIC PEDIATRIC EYE DISEASE AND BALTIMORE PEDIATRIC EYE DISEASE STUDIES (NEI.2011)
4. HEALTH POLICY INSTITUTE. Vision Screening” Should Be Called “Amblyopia Screening”
5. ATTENTION DEFICIT HYPERACTIVITY DISORDER: EFFECTIVENESS OF TREATMENT IN AT-RISK PRESCHOOLERS; LONG-TERM EFFECTIVENESS IN ALL AGES; AND VARIABILITY IN PREVALENCE, DIAGNOSIS, AND TREATMENT. COMPARATIVE EFFECTIVENESS REVIEW NO. 44. AHRQ PUBLICATION NO. 12-EHC003-EF. ROCKVILLE, MD: AGENCY FOR HEALTHCARE RESEARCH AND QUALITY. OCTOBER 2011. AVAILABLE AT: EFFECTIVEHEALTHCARE.AHRQ.GOV/REPORTS/FINAL.CFM.