Early detection of children’s vision problems is essential to make sure your kids have the visual skills they need to do well in school, sports and other activities. Vision is arguably the most important of the five senses. It plays a crucial role throughout childhood and beyond.
From infancy on, there are important milestones in your child’s vision development. For example, during the first several months of life, a baby can focus only on objects up close. Those objects will be seen in high contrast colors only, such as black, white and red. But by six months of age, your child’s visual acuity should be much sharper, with more accurate color vision and better eye movement and eye-hand coordination skills.
At this point you should have your child’s eyes examined by a pediatrician or an eye doctor, to make sure their eyes are working together as a team during the early formative years. Otherwise, a lifetime of poor vision in one or both eyes may result
Moving into the preschool and school-age years, parents face a new set of worries:
Parents of school-age children should stay informed about vision correction options, such as using contact lenses instead of glasses to control nearsightedness and protective sports eye wear. Ensuring that children wear sunglasses is very important, too.
During the preschool years from ages 3 to 6, your child will be fine-tuning the vision he has already developed during the infant and toddler years. Young preschoolers are learning to ride tricycles and master the complex hand-eye coordination needed to pedal, steer and watch where they’re going at the same time.
Older preschoolers are learning how to use more sophisticated sports equipment such as and working on the fine motor skills needed to write their names.
At this stage, most children have passed that crucial time during infancy where many childhood visual problems develop. Parents need to look for refractive errors in their preschoolers by watching for these warning signs:
Schedule an appointment with your eyecare practitioner if your preschooler exhibits any of these possible refractive error signs. Farsightedness is very common in young children. Excessive farsightedness can lead to strabismus, which is also still very common in children this age. Sometimes the excessive farsightedness can simply be corrected with glasses, and the crossed eye resolves. A severely crossed eye may require surgery. Untreated strabismus can lead to amblyopia. If not treated, eventually the amblyopic eye “shuts off” and vision may be permanently lost.
Nearsightedness, on the other hand, requires immediate correction with glasses. A child’s eye can’t compensate for the blurry distance vision like it can for the blurry near vision. Astigmatism will also lead to blurry, distorted vision if your child has a moderate amount, and requires correction with glasses.
The First Eye Exam
If your child exhibits no symptoms of a refractive error or other visual problems, he should have an eye exam by the age of 6 months, then again at age 3, according to the American Optometric Association (AOA). Having a complete eye exam before the child enters school allows enough time to catch and correct any problems while the visual system retains flexibility and elasticity. Children without symptoms should receive an eye exam again right before beginning school.
Should your child require correction for any visual problem, be it nearsightedness, farsightedness or strabismus, the AOA recommends an exam every year. A yearly exam allows your eyecare practitioner to stay on top of your child’s visual needs, as well as ensure that your child’s prescription for eyeglasses or contact lenses is still correct. The visual system is developing along with your child, so annual prescription changes are common.
Make sure your child receives a comprehensive eye exam from an eye care practitioner, not just screenings from school nurses or pediatricians. Screenings may help spot problems, but they can easily miss them, too, because they are not complete tests. And screenings are typically administered by people who don’t have enough eye-specific training in order to catch all vision and eye health problems. Read more about why you can’t rely on vision screenings alone.
Motivation to Wear Eyeglasses
If your child needs to wear eyeglasses, get him involved in the frame purchase — if he’s the one who picks out the frame, he will be more motivated to wear the glasses. Explain that he needs them to see clearer, and give specific examples that he can understand. He’ll be able to see the words in his books better, or will be able to play catch with his brother because he can now see the ball.
Schedule the eye exam and glasses selection at a time that’s good for your child. Some kids are more focused early in the day, while others come to life after lunch or an afternoon nap. Don’t visit the eye doctor when your child is tired, cranky or hungry. First select a few frame styles yourself, then give your child the final choice on the glasses he’ll wear. Make the outing a positive event, discussing how lots of people he knows wear glasses, and how they see much better.
Make sure the frames you choose are comfortable to wear, and fitted properly for your child. No one, especially a child, will wear uncomfortable glasses.
Your child’s vision is the most important tool he has to succeed in school. When his vision suffers, chances are his schoolwork does, too. In fact, up to 25 percent of schoolchildren may have vision problems that can affect their ability to learn, according to the College of Optometrists in Vision Development. School-age children also spend a lot of time in recreational activities that require good vision. After-school team sports or playing in the backyard aren’t as fun if you can’t see well.
Refractive errors (poor visual acuity or the presence of astigmatism) are eyecare practitioners’ main concern for school-age children. Parents, as well as teachers, should keep a watchful eye out for these 13 signals that a child’s vision needs correction:
Schedule an appointment with your eyecare practitioner if your child exhibits the above signs. A visit with the doctor may reveal that your child is nearsighted, farsighted or astigmatic. These three refractive errors are easily corrected with glasses or contact lenses.
Blurry vision may be interfering with your child’s ability to learn in school. Regular eye exams can detect and correct this and other vision problems.
Learning disabilities are another concern with school-age children. Although learning disabilities usually occur in children ages 1 through 7, sometimes they are not picked up until later school years. Many times learning differences are thought of as simply a visual problem. Sometimes a refractive error can be the cause of difficulty in school. Or a refractive error may be combined with a learning problem.
If your child frequently reverses letters while reading or writing, exhibits poor handwriting, dislikes or has difficulty with reading, writing or math, consistently mistakes his left for his right or vice versa, can’t verbally express himself or consistently behaves inappropriately in social situations, seek help. Consult your eyecare practitioner to rule out a visual problem as the cause, and visit your pediatrician for additional information and referrals to specialists.
Learning Related Vision Problem
Vision and learning are intimately related. In fact, experts say that roughly 80 percent of what a child learns in school is information that is presented visually. So good vision is essential for students of all ages to reach their full academic potential.
When children have difficulty in school — from learning to read to understanding fractions to seeing the blackboard — many parents and teachers believe these kids have vision problems. And sometimes, they’re right. Eyeglasses or contact lenses often help children better see the board in the front of the classroom and the books on their desk. Ruling out simple refractive errors is the first step in making sure your child is visually ready for school. But nearsightedness, farsightedness and astigmatism are not the only visual disorders that can make learning more difficult.
Less obvious vision problems related to the way the eyes function and how the brain processes visual information also can limit your child’s ability to learn. Any vision problems that have the potential to affect academic and reading performance are considered learning-related vision problems.
Vision and Learning Disabilities
Learning-related vision problems are not learning disabilities. Learning disabilities do not include learning problems that are primarily due to visual, hearing or motor disabilities. Mental retardation and emotional disturbances also are excluded as learning disabilities, along with learning problems related to environmental, cultural or economic disadvantage. If your child habitually places her head close to her book when reading, she may have a vision problem that can affect her ability to learn.
But specific vision problems can contribute to a child’s learning problems, whether or not he has been diagnosed as “learning disabled.” In other words, a child struggling in school may have a specific learning disability, a learning-related vision problem, or both. If you are concerned about your child’s performance in school, you need to find out the underlying cause (or causes) of the problem. The best way to do this is through a team approach that may include the child’s teachers, the school psychologist, an eye doctor who specializes in children’s vision and learning-related vision problems and perhaps other professionals. Identifying all contributing causes of the learning problem increases the chances that the problem can be successfully treated.
Types of Learning-Related Vision Problems
Vision is a complex process that involves not only the eyes but the brain as well. Specific learning-related vision problems can be classified as one of three types. The first two types primarily affect visual input. The third primarily affects visual processing and integration.
Eye health and refractive problems. These problems can affect the visual acuity in each eye as measured by an eye chart. Refractive errors include nearsightedness, farsightedness and astigmatism, but also include more subtle optical errors called higher-order aberrations. Eye health problems can cause low vision — permanently decreased visual acuity that cannot be corrected by conventional eyeglasses, contact lenses or refractive surgery.
Functional vision problems. Functional vision refers to a variety of specific functions of the eye and the neurological control of these functions, such as eye teaming (binocularity), fine eye movements (important for efficient reading), and accommodation (focusing amplitude, accuracy and flexibility). Deficits of functional visual skills can cause blurred or double vision, eye strain and headaches that can affect learning. Convergence insufficiency is a specific type of functional vision problem that affects the ability of the two eyes to stay accurately and comfortably aligned during reading.
Learning problems can lead to depression and low self-esteem. Seeing an eye doctor should be one of your first steps. Perceptual vision problems. Visual perception includes understanding what you see, identifying it, judging its importance and relating it to previously stored information in the brain. This means, for example, recognizing words that you have seen previously, and using the eyes and brain to form a mental picture of the words you see.
Unfortunately, most routine eye exams evaluate only the first of these categories of vision problems — those related to eye health and refractive errors. However, many optometrists who specialize in children’s vision problems and vision therapy offer exams to evaluate functional vision problems and perceptual vision problems that may affect learning.
Color blindness, though typically not considered a learning-related vision problem, may cause problems in school for young children with color vision problems if color-matching or identifying specific colors is required in classroom activities. For this reason, all children should have an eye exam that includes a color blind test prior to starting school.
Symptoms of Learning-Related Vision Problems
Symptoms of learning-related vision problems include:
If your child shows one or more of these symptoms and is experiencing learning problems, it’s possible he or she may have a learning-related vision problem. To determine if such a problem exists, see an eye doctor who specializes in children’s vision and learning-related vision problems for a comprehensive evaluation. If no vision problem is detected, it’s possible your child’s symptoms are caused by a non-visual dysfunction, such as dyslexia or a learning disability. See an educational specialist for an evaluation to rule out these problems.
Signs Of Attention And Developmental Disorders
Many people know attention disorders by the names attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (ADHD). Frequently such children are put on drugs like Ritalin. Occasionally children with attention disorders experience other problems that contribute to inattentiveness, such as a speech and language dysfunction or nonverbal disorder. Consult a pediatric neurologist for a definitive diagnosis. Parents can easily identify the three components of the autism spectrum disorder: lack of eye contact, inability to relate socially or inappropriate social interaction, and unusual repetitive interests that exclude other activities. Any or all of these early signs should prompt a consultation with your family doctor or pediatrician.
Treatment of Learning-Related Vision Problems
If your child is diagnosed with a learning-related vision problem, treatment generally consists of an individualized and doctor-supervised program of vision therapy. Special eyeglasses also may be prescribed for either full-time wear or for specific tasks such as reading.
If your child is also receiving special education or other special services for a learning disability, ask the eye doctor who is supervising your child’s vision therapy to contact your child’s teacher and other professionals involved in his or her Individualized Education Program (IEP) or other remedial activities. In some cases, vision therapy and remedial learning activities can be combined, and a cooperative effort to address your child’s learning problems may be the best approach.
Also, keep in mind that children with learning difficulties may experience emotional problems as well, such as anxiety, depression and low self-esteem. Reassure your child that learning problems and learning-related vision problems say nothing about a person’s intelligence. Many children with learning difficulties have above-average IQs and simply process information differently than their peers.
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