Learning-Related Vision Problems

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. You’ll want to ensure 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 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 they 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 they see, judge its importance, and associate it with previous visual information stored in their 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 important visual skills 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. 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). The study also concluded 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 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, 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.

Vision therapy

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 their 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.

After your child’s comprehensive vision exam, we will advise you about whether a program of vision therapy would be helpful. If we don’t provide the services we believe your child needs, we will refer you to a children’s vision specialist or education/learning specialist who does.

How to tell if Your Child Needs Glasses

Keeping your children happy and healthy is a parent’s number one concern. It is easy to tell when your child feels ill and needs to see a doctor, but how do you know if your child is having difficulties seeing?

There are common signs that your child is having difficulty seeing. If your child is showing one or more of the below signs, you should contact your eye doctor for an examination.

Avoiding activities?

The first way to tell if your child has a vision problem is when they won’t take part in fun activities such as coloring, reading or making things with their hands. Although every child has certain activities they dislike due to personal preferences – a child who decides to sit out while their friends play with bricks, coloring books and games may be suffering from poor vision.

Tired eyes?

Being a child can be exhausting; all that running around in the yard, playing with friends and making hideouts out of bedding would cause anyone to be tired. But there is a line between when your child should be rubbing their eyes due to tiredness (around naptime or bedtime) and when they may be feeling discomfort in their eyes. A child who rubs their eyes, or has watery or red eyes on more than one occasion, may also be struggling to see.

Sitting too close to TV and games consoles?

Another warning sign – and usually the most obvious one – is when your child turns on the TV and sits too close to the screen. In the average living room the TV may be approximately 5 meters away from your couch; an acceptable distance. If you see your child sitting very close to the screen, you may have a problem.

Headaches and frowning?

It’s normal for the occasional bump and bruise as your child explores their world and is active in the classroom. But if your child walks around rubbing her head regularly, complaining of a headache or squinting around bright lights – she may have a vision problem. When we have poor eyesight we find it hard to focus on objects either close up or at a distance. If you need a visual aid but don’t use one, your eyes work overtime to try and focus on that object. This causes  muscles in the back of the eye to tense up, resulting in headaches over the eyes.

Lack of concentration?

Another way to tell if your child has a vision problem is their inability to focus on the task in hand. Those same muscles are working overtime to focus, which can cause your child to feel restless and uncomfortable. The result is them not paying attention for long periods of time at school or at home.

What to do: 

If you feel your child may have a vision problem, and she exhibits one or more of the signs mentioned above, it is really important that you take them to an optometrist as soon as possible. Speak to your child about your concerns and explain that an eye test is not painful. If it turns out that your child does need glasses, gently tell them that this is the case and remember that wearing glasses is not a bad thing. There are many glasses styles available for kids, so not only will they look fashionable and cool – they will also be more comfortable in the classroom and participating in activities.

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 eye exam at 6 months of age. They should go back to the eye doctor around age 3, then again 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.

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

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, they may refer an optometrist for further evaluation. Eye doctors have specific equipment and training to help them detect and diagnose 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’ll fill out a form all about your child’s health. The health history form will ask about your child’s birth history (also called perinatal history), such as birth weight and whether or not 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 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 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 your child’s previous ocular diagnoses and treatments like 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 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 observing 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 be examining your child’s eyes for signs of these eye and vision problems commonly found in young children:

  • Amblyopia. Also commonly 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 which 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 successfully treated 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.

Are Contact Lenses a Good Choice for Kids?

A common question many parents have about contact lenses and kids is: “When is my child old enough to wear contact lenses?”

Physically, your child’s eyes can tolerate contact lenses at a very young age. Some babies are fitted with contact lenses due to eye conditions present at birth. And in a recent study that involved fitting nearsighted children of ages 8-11 with one-day disposable contact lenses, 90% had no trouble applying or removing the contacts without assistance from their parents.

A matter of maturity

So the important question is whether or not your child is mature enough to insert, remove and take care of their contact lenses. How they handle other responsibilities at home will give you a clue. If your child has poor grooming habits and needs frequent reminders to perform everyday chores, they may not be ready for the responsibility of wearing and caring for contact lenses. But if they are conscientious and handle these things well, they may be excellent candidates for contact lens wear, regardless of their age.

Contact lenses for sports

Many kids are active in sports. Contact lenses offer several advantages over glasses for these activities. Contacts don’t fog up, get streaked with perspiration or get knocked off like glasses can. They also provide better peripheral vision than glasses, which is important for nearly every sport. There are even contact lenses with special tints to help your child see the ball easier.

For sports, soft contact lenses are usually the best choice. They are larger and fit closer to the eye than rigid gas permeable (GP) lenses, so there’s virtually no chance they will dislodge or get knocked off during competition.

Controlling nearsightedness

If your young son or daughter is nearsighted, rigid gas permeable (GP) contacts may be the best choice. In some cases, GP contact lenses may slow the progression of myopia in children. (Soft lenses don’t offer this potential benefit.) Also, GP lenses are more durable and often provide sharper vision than soft contacts.

Building self-esteem with contact lenses

Contact lenses can do wonders for some children’s self-esteem. Many kids don’t like the way they look in glasses and become overly self-conscious about their appearance because of them. Wearing contact lenses can often elevate how they feel about themselves and improve their self confidence. Sometimes, even their school performance and participation in social activities improves after they switch to contact lenses.

Glasses are still required

If your child chooses to wear contact lenses, they still need an up-to-date pair of eyeglasses. Contact lenses worn on a daily basis should be removed at least an hour before bedtime to allow the eyes to “breathe.” Also, there will be times when your child may want to wear their glasses instead of contact lenses. And contact lenses should be removed immediately any time they cause discomfort or eye redness.

Don’t push contacts on your kids

Motivation is often the most important factor in determining whether your son or daughter will be a successful contact lens wearer. If you wear contact lenses yourself and love them, that still doesn’t mean they are the right choice for your child. Some children like wearing glasses and have no desire wear contact lenses.

We can usually tell at your child’s contact lens consultation if they really want to wear contact lenses. If it appears that they would rather stay in glasses, we will certainly respect their decision – and you should, too.

Sometimes it’s just a matter of timing. Often, a child may feel they don’t want contacts, but a year or two later, they do. There’s always time to make that decision.

When your child is ready to try contacts

When you and your child agree it’s time for contacts, call our office to schedule a contact lens consultation. We welcome the opportunity to help kids of all ages enjoy wearing contact lenses.

For more information on whether contact lenses might be a good fit for your child, schedule an appointment with our team today!