Does this child have a visually-based problem?
Our children present with a vast array of problems affecting their development and academics. Sensory problems, trauma, autism, behavior, ADHD and the list goes on. Our children get assessed by OTs, and PTs, neurologists, neuropsychologists, and pediatricians. But did they have an eye exam? A complete eye exam? Only 40% of children have had their eyes examined by an eye doctor. (1) That leaves all of those children potentially walking around with vision problems affecting their academic and developmental development. Meanwhile, we attempt to teach them to catch a ball or write the alphabet or button a button.
“Does he need an eye exam?”
YES!!! Every child, regardless of academic performance or another diagnosis, needs a complete eye exam with a binocular vision assessment and cycloplegic dilation, even if the child has never complained about their vision. Many times, when a child is assessed with the Convergence Insufficiency Symptom Survey, they learn that they are not supposed to see “words moving” on the page or see double when they read. They had symptoms and were not even aware. Most children with ocular motor or near vision problems will read letters on a chart without difficulty. 20/20 means only that each eye has good acuity. It does not tell us how well the eyes are working together or how hard the eyes are working to make that 20/20 acuity. Only a complete eye exam with binocular assessment and cycloplegic dilation can give the whole picture.
“Is this is a visually-based problem?”
There are many signs a child is having a visual-based problem.
- Eye rubbing
- unexplained headaches
- poor handwriting
- poor reading skills that do not improve with tutoring
- head turning or tilting when reading
- closing one eye while reading
- poor visual-motor integration that does not improve practice
- poor balance or motion sensitivity
- Diagnosed ADHD that does not respond to medication
- unable to catch a ball
- letter reversals
- visual perceptual problems
- spacing and size problems during handwriting tasks
- fine motor delays
- poor depth perception
“Who do I send them to, to make sure they a complete eye exam?”
A good place to start is the College of Optometrists in Visual Development. These doctors specialize in the assessment and treatment of eye movement disorders and near vision focusing problems that could be affecting academic performance. You can find your local COVD doctor with the search tool on the site. One might also look for an optometrist that specializes in pediatrics or binocular vision.
When an appointment is made, be specific about symptoms and ask for a “binocular vision assessment”.
Every child needs a complete eye exam. Parents may have many reasons to not get this done, but you cannot teach a child to read or write, or catch a ball that cannot see.
Want to learn more?
The Pediatric Ocular Motor Toolkit contains more information on how you can assess treat ocular motor problems
1.Children’s Vision Screening and Intervention. (n.d.). Retrieved from https://nationalcenter.preventblindness.org/childrens-vision-screening-and-intervention