Vision is More Than 20/20

Unfortunately, parents and educators often incorrectly assume that if a child passes a school vision screening, then there is no vision problem. However, school vision screenings often only test for visual acuity.

In reality, the vision skills needed for successful reading and learning are much more complex. A child who can see 20/20 (or 6/6) can still have a vision problem. Vision is a complex process that involves over 20 visual abilities and more than 65% of all the pathways to the brain. One in four children has an undiagnosed vision problem which can interfere with learning and lead to academic and/or behavioral problems. However, it is important to know that these children frequently do not report symptoms because they think everyone sees the same way they do. Often a child with a vision-based learning problem has excellent verbal skills, causing parents and educators to think the child must be lazy, have ADD/ADHD, or is learning disabled. The possible misdiagnosis can be due to similar symptoms, but the causes are not the same.

The following tests should be included in a comprehensive vision exam:

 Comprehensive Vision Exam

A thorough patient history, including general health and developmental history.

A measurement of how clearly the patient can see in the distance and up close (visual acuity, e.g. 20/20)

A measurement of the presence of any refractive errors (nearsightedness, farsightedness, or astigmatism)

An assessment of eye focusing, eye teaming, and eye movement abilities (accommodation, binocular vision, ocular motility)

An examination of the health of the eyes 
 Depending on the results of these evaluations, additional tests of visual development and visual perceptual abilities may be needed to effectively assess a patient's total visual status. Testing with eye drops is sometimes used to evaluate the refractive status or health of the eyes. However, these eye drops can alter test results and mask significant visual problems. Therefore, testing with eye drops should be deferred until after the first comprehensive vision examination. A complete functional evaluation of all visual abilities should be conducted first. Any reading or learning difficulties experienced by you or your child should be brought to the attention of the doctor. Request an evaluation to detect whether learning-related vision problems are present. Once testing is completed, the Optometrist should review all findings with the patient or parent and provide consultation and recommendations regarding any needed treatment.