The school year is well under way but some students continue to struggle with reading. Even with the special help at home and at school, the hoped for gains remain out of reach. Parents devote extra time helping with homework and reading yet, out of frustration, might complain, “If only you would work harder!” Teachers use the best curricula available. But, your student falls even further behind, discouragement settles in and the student exhibits secondary behaviors — loss of attention, deteriorating behavior, plummeting self-esteem. Of course there are students who will persist as hard as they can but suffer for it with headaches, stomachaches, anxiety or fatigue.

Since 1996, as a developmental and rehabilitative vision specialist, I have worked with hundreds of students with stories like this. Most schoolwork is presented visually yet millions of children have never had a comprehensive eye assessment with an eye care professional. Many have had a screening and been told their vision is fine because they have “20/20 vision.”

However, there is a problem if we equate good eyesight — one eye at a time, looking at a chart across the room — with vision. Clarity of eyesight is just one of many visual abilities that are essential to how well we function in the world and meet the demands of school, work, sports and hobbies.

The standard eye chart for measuring eyesight — the “Snellen” chart — was introduced in the 1860’s. This one-eye-at-a-time, in-the-distance measurement does not measure how well you see using two eyes together at a close reading distance; nor if you have stamina, or visual accuracy and comfort all day long; nor how well you can process and analyze visual information. Can we really rely on a 19th century measurement to assess our readiness to meet 21st century demands?

“Your child may have 20/20 eyesight and still have a vision problem,” says Dr. Lynn Hellerstein, past-president of The College of Optometrists in Vision Development and author of See It, Say It, Do It: The Parent’s and Teacher’s Guide to Creating Successful Students & Confident Kids.

A reader must efficiently integrate many visual abilities to achieve successful fluent reading, including: aiming both eyes at the same point, at the same time; focusing both eyes accurately; sustaining focus at a near-point reading distance while coordinating eye movements across lines of print. If any one of these abilities is not well developed or has broken down from fatigue, stress, or trauma, then vision is not going to be easy, accurate, or comfortable.

If a reader struggles with eye control, comprehension suffers. Some students will compensate, knowing they have to reread the material to understand it. Others give up.

Students with undiagnosed vision problems exhibit a wide range of behaviors and symptoms that can be mistakenly attributed to other causes. Attention problems, frustration, headaches, stomachaches, difficulty learning to read, skipping lines or words, or not working up to their potential are just a few of the symptoms of vision problems.

Symptoms of Vision Problems

• Difficulty with reading
• Short attention span
• Easily distracted
• Reads slowly
• Poor comprehension
• Skips words
• Confuses, forgets or reverses letters, numbers or words
• Moves head closer or farther from near work
• Print comes in and out of focus
• Print runs together or jumps around
• Eyes tire or hurt after reading
• Light sensitivity
• Headaches
• Closes or covers one eye
• Frustration

Children rarely talk about having a problem with their vision. The print might go in and out of focus or words might appear to move on the page, but because they cannot compare their vision to anyone else, they may assume that how they see is the way everyone sees.

How many students have gone through their school years never able to fully meet their potential? Who have had to work harder they should? Who have given up? Several states have recognized the critical link between vision and school success and require a professional vision evaluations.

Clear eyesight and good eye health are at the foundation of visual readiness for school but other critical visual abilities can be assessed and ruled out or revealed as an underlying cause of a reading problem. Information and research studies are available to help parents and educators understand the profound impact hidden eye problems can have on school success. The visual demands of schoolwork can be daunting for the student with undetected vision problems. Do you know the signs and symptoms of when a reading problem could really be a vision problem?

Penelope Youngfeather, MS, COVT has a Master’s Degree in Early Childhood Special Education. She is a certified optometric vision therapist serving students of all ages and is the Director of the Lifetime Eye Care Vision Therapy Center in Eugene and can be reached at LifetimeEyeCare.net.

Resources for More Information

College of Optometrists in Vision Development covd.org

Parents Active for Vision Education PaveVision.org

Nebraska Foundation for Children’s Vision nechildrensvision.org

Optometric Extension Program Foundation oepf.org

Optometrists Network Optometrists.org

Lifetime Eye Care LifetimeEyeCare.net