The summer is winding down, and back-to-school is on almost every parent’s thoughts. As a “doctor in training”, I’ve been thinking about my amazing summer internship at The Michigan College of Optometry externship site, Wow Vision Therapy in St. Joseph, Michigan. What especially amazed me was the number of children that we see in this clinic that have learning-related component to their vision problem. At the beginning of each child’s treatment plan, we ask the parent what they expect vision therapy will do to help their child. Almost every patient has school-related goals. In optometry school, we talk about the fact that 1 in 4 children suffers from an undiagnosed vision problem and that 1 in 8 children suffers from a binocular vision problem known as Convergence Insufficiency, but until I came to this practice, I didn’t realize just how many families are affected by this. When a child struggles in school, it’s not just a problem for them; the entire family is affected.
Seeing so many children with vision problems causing them to struggle in school made me start thinking about how these children even began to realize that they had a vision problem. I have had the opportunity to speak with a number of our patients’ parents. It’s amazing how often I hear that the visual system was the last thing on their minds when their child started to have problems in school. Vision-related learning problems can often manifest in ways that don’t always suggest that the visual system is at the root of the problem. Common symptoms include problems with reading comprehension or fluency, avoidance of reading, headaches or eyestrain after near work, poor handwriting, or attention problems. It’s easy to think that these problems could be academic or behavioral, but a visual dysfunction can be all-too-often to blame. Imagine how hard it would be to pay attention or to be interested in reading if the words were doubled on the page or looked like they were moving around! It would be hard to read efficiently or have neat hand writing if everything you see up close is blurry!
Detecting vision-related learning problems can be a difficult task for parents. I often hear that the child had a school vision screening, but they passed with 20/20 vision! Now I’m starting to remind parents that 20/20 vision is only a small piece of the puzzle. Most people think of 20/20 as “perfect vision,” but there are a whopping 17 skills that are necessary for efficient learning! A list of these skills can be found at the COVD website on Children's Vision and Learning Month. Children who struggle with these skills may not realize that they have a problem. They don’t know how other people see, so they may not realize that they should not have to struggle to keep their vision clear, comfortable, and single.
The best way to make sure that you child does not have a learning-related vision problem is to have a comprehensive eye exam from an optometrist who is trained to identify and recommend the necessary treatment for vision-related learning problems. The American Optometric Association has outlined the best practices for this in a Clinical Practice Guideline (CPG) entitled Care of the Patient with Learning Related Vision Problems. In this CPG, under Early Detection (pg 8-9) it says, “because the evidence that learning related vision problems can be prevented to any substantial degree is inconclusive, the emphasis is on early detection. It is recommended that vision examinations be scheduled at 6 months, 3 years of age and at the entry into school…” Too often, parents rely on school vision screenings to tell them if their child has a vision problem. These, however, may not be enough. School screenings usually test for only distance visual acuity and possibly any overt eye muscle problem. This leaves out the vast majority of the 17 necessary skills. Even with the screenings in place, 1 in 4 children suffer from undiagnosed vision problems! A comprehensive vision examination with a focus on the vision problems that can affect learning will detect these problems before your child begins to struggle in school. It is with these insights that I hope will lead to fewer parent oversights. For those parents who read this story, make sure your child is seen by an optometrist who knows how to recognize the 17 vision skills! Make a comprehensive vision exam a priority to your back-to-school checklist this year!
To find out if your optometrist will recognize a vision-related learning problem simply use the 17 skills checklist and ask before making your appointment. You can also contact the American Optometric Association at www.aoa.orgor
April A. Jones4th Year Intern,