Vision Problems of Schoolchildren

By Gretchyn Bailey

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 eye care 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:

1. Consistently sitting too close to the TV or holding a book too close
2. Losing his place while reading
3. Using a finger to follow along while reading
4. Squinting
5. Tilting the head to see better
6. Frequent eye rubbing
7. Sensitivity to light
8. Excessive tearing
9. Closing one eye to read, watch TV or see better
10. Avoiding activities which require near vision, such as reading or homework, or distance vision, such as participating in sports or other recreational activities
11. Complaining of headaches or tired eyes
12. Avoiding using a computer, because it "hurts his eyes"
13. Receiving lower grades than usual

Schedule an appointment with your eye care 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

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 eye care practitioner to rule out a visual problem as the cause, and visit your pediatrician for additional information and referrals to specialists.

Eye Exams: How Often?

According to the American Optometric Association, children should have an eye exam by no later than 6 months old, then again by age 3, and just before starting school. School-age children need an exam every two to three years after that if they have no visual problems. But if your child requires eyeglasses or contact lenses, schedule visits every 12 months.

Prescriptions change frequently, because vision matures along with your child. Your eye care practitioner will also ensure that your child has the visual skills necessary for succeeding in school, such as using the eyes as a team, peripheral vision, ease of focusing from distance to near and eye/hand coordination.

The Problem with Vision Screenings

Keep in mind that a vision screening performed by your pediatrician or the school nurse is not a comprehensive eye exam. These screenings are designed to alert parents to the possibility of a visual problem, but not take the place of a visit to an eye care practitioner. Sometimes screenings are helpful, but they can miss serious vision problems that your eye care practitioner would catch. One study found that 11.3 percent of children who passed a vision screening were found to have a vision problem in need of correction.*

Another problem with school or pediatrician screenings is that sometimes no follow-up occurs even when a vision problem is detected. According to one study, 50 percent of parents were unaware two months later that their child had failed a vision screening.** In another study, 80 percent of the kindergarten-age children examined who were found to have a vision problem had visited a primary care physician in the past 12 months, but fewer than 20 percent had been told to see an eye doctor.† Another study found that when a 5- or 6-year-old failed an initial vision screening, the average delay before evaluation by an eye care professional was more than four years.††

Some pediatricians don't even perform vision screenings on all their patients. One study found they did not perform vision screening on one-third of children, including 60 percent of three-year-olds.††† This is why you, as a responsible and caring parent, must take the initiative and schedule your child for complete, periodic exams by an eye care practitioner.

Click here to learn what to expect in a children's eye exam.

*Poterio et al., Journal of Pediatric Ophthalmology and Strabismus, Vol. 37, No. 2
**Wasserman et al., Pediatrics, Vol. 89, No. 5
†Zaba et al., Journal of Behavioral Optometry, Vol. 14, No. 5
††Yawn et al., Journal of School Health, Vol. 66, No. 5
††† Wasserman et al., Pediatrics, Vol. 89, No. 5
Thanks to The Vision Council, which compiled these statistics.

[Page updated April 2008]