Community Fellow,. Vision problems affect nearly 13.5 million children in the U.S. Students, especially young ones, may not

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Vision problems affect nearly 13.5 million children in the U.S.

Students, especially young ones, may not know that what they are experiencing is a vision problem

Leads to frustration and worsening academic performance


Teachers are in a unique position to notice a child with a vision problem◦ See children for

many hours a day◦ See children in an

academic setting where visual acuity is required


Discovering vision problems early on in a child’s life is an important part of helping him or her do well in school. Avoid frustration Make reading easier Make learning more enjoyable

In the case of some vision conditions (covered later), early detection and treatment is the only way to prevent loss of sight in the afflicted eye


The following may be indicative of a child experiencing a vision problem:

• Eyes tiring while reading or doing other schoolwork

• Turning or tilting head to use one eye only

• Making frequent reversals while reading or writing

• Using finger to maintain place while reading

• Consistently performing below potential

• Eyes turning inward or outward

• Squinting• Headaches• Worsening academic

performance• Blurred or double vision• Losing place while

reading• Avoiding close work• Holding reading material

closer than normal• Rubbing eyes


If you notice a child struggling with any of these symptoms, he or she may be experiencing a vision problem

The next step is to make sure that child has an eye exam by an eye doctor


Eye ExamsPerformed by

optometrists or ophthalmologists

ThoroughCan detect many

vision problems and/or eye disorders and diagnose them

Vision screenings(insignificant)

Performed by non-specialist health staff

Provide baseline VA Do not test for eye

disorders, cannot provide diagnostic information


Test only distance visual acuity. Fail to detect children who have reading

problems, hyperopia, or astigmatism. Vision screenings are subjective

◦A research study found that two school nurses matched on their vision screening results for only 86.4% of the students. Ore, L., Tamir, A., Stein, N., and Cohen-Dar, M. “Reliability of Vision Screening Tests for School Children.” Journal of Nursing Scholarship. 41.3 (2009): 250-259.


A study in New York City schools found that 41% of children who passed a distance visual acuity test still needed to be examined by an eye doctor for other reasons.

Screening solely for reduced visual acuity may miss up to 40% with potential vision problems.Bodack, M., Chung, I., and Krumholtz, I. “An Analysis of Vision Screening Data from New York City Public Schools.” Journal of the American Optometric Association. 81.9 (2010); 476-484.


Do not assume that children with eyeglasses have recently had an eye exam.

A research study found that 49% of eyeglass-wearing children failed a visual assessment. 28% of non-eyeglass-wearing children failed the visual assessment. “Children Unable to Perform Screening Tests in Vision in Preschoolers Study: Proportion with Ocular Conditions and Impact on Measures of Test Accuracy.” Investigative Ophthalmology and Visual Science. 48 (2007):83-87.


A research study was conducted in California high schools among students who were identified by their teachers as “poor readers”.

17% of the students had deficient visual acuity (20/40 or worse in one eye)

80% of the children were inadequate or weak in at least one of the following visual skills: binocular fusion ranges at near, accomodative facility, and convergence near point.

80% of the students passed the visual acuity testing, but only 20% had adequate visual skills. Grisham, D., Powers, M., and Riles, P. “Visual skills of poor readers in high school.” Journal of the American Optometric Association. 78.10 (2007); 542-549.


Visits to an eye doctor can be expensive

Not everyone has health insurance that covers the cost of eye exams

CHIP◦ Each state has the Children’s

Health Insurance Program (CHIP) which can cover the cost of eye exams for children of families that qualify

◦ For information on your state’s program, go to www.insurekidsnow.gov

◦ You can also call (877)-KIDS-NOW


Vision USA◦ Through the American Optometric

Association◦ Has its own requirements◦ Provides basic eye care services

for those who are uninsured and do not qualify for government assistance

◦ www.aoa.org/visionusa◦ (800)-766-4466


Nearsightedness (myopia)◦ Most common visual problem

among students◦ A type of refractive error◦ Close objects are clear◦ Far-away objects are blurry◦ Students may squint to see

blackboard or presentation materials

◦ Can be corrected with corrective lenses such as glasses or contact lenses


Farsightedness (hyperopia)◦ Also a common visual problem

among students◦ A type of refractive error◦ Close objects are blurry◦ Far-away objects are clear◦ Students may squint while

reading or hold reading material farther away from face than normal

◦ Can be corrected with corrective lenses such as glasses


Astigmatism◦ Often co-occurs with

nearsightedness or farsightedness

◦ A type of refractive error caused by an abnormally shaped cornea

◦ Can be corrected with corrective lenses such as glasses or contact lenses


Strabismus◦ Issue with eye muscles◦ Student’s eyes appear to be

focusing on two different points◦ Often co-occurs with amblyopia◦ Glasses or eye muscle exercises

can treat strabismus. Sometimes surgery is needed.


Lazy Eye (Amblyopia)◦ One eye is stronger than the other◦ Student may show signs of

strabismus, but the two do not always co-occur

◦ Over time, the brain may begin to disregard signals from the weaker eye

◦ If it is not detected early, amblyopia can lead to a permanent loss of sight in the weaker eye

◦ This disorder is only detectable through an eye exam from an optometrist or ophthalmologist


Pink Eye (Conjunctivitis)◦ Common in schoolchildren◦ The conjunctiva (lining on eyelid

and part of eyeball) become infected and inflamed

◦ Highly contagious◦ Prescription eye drops can treat

bacterial forms◦ Viral forms clear up on their own

and cannot be treated, but sometimes eye drops are needed to relieve inflammation.


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Community Fellow,. Vision problems affect nearly 13.5 million children in the U.S. Students, especially young ones, may not