20/20 Vision? How Vision Problems Affect School Work

   About a month ago, I was awakened early in the morning by a call from my auto-mechanic. “Your front passenger-side wheel is loose and about to fall off.” 

   Hmm…this would explain the strange whimpering-like noises and the wobbling on the highway. “It will be $685 to replace the parts” he said. “Do you want me to fix it?” Of course the answer was yes. Still, his ‘diagnosis’ made me realize that I should have brought the car in sooner, despite my busy schedule.

    Later that day, after the car had been fixed and I was driving home from work, I thought of my morning spent talking to the mechanic, and of my afternoon spent talking to patients. “Really,” I thought, “I have the same conversation with parents as the mechanic had with me.”

    As a doctor of optometry, I see many children whose undetected visual disorders are often causing them great difficulty with school work. Just as I could not have known what was wrong with my car, parents cannot be expected to know which vision disorders their children may have. But parents with children who are struggling in school should bring them for a thorough eye examination; one that includes tests at the distance at which a child actually reads.

    Most eye exams primarily check for “20/20 eyesight”. This is a measure of one’s eyesight when viewing black letters on a white background 20 feet away. Most of our viewing, however, takes place at much closer distances. Since few people have arms that are 20 feet long, how does seeing well at 20 feet tell us anything about how a child reads at 15 inches? 

    A standard “20/20” eye test identifies only about 5 percent of vision problems in children.  An eye chart can't check how well children coordinate their eyes when reading,  how easily they can adjust focus from near to far distances, or their ability to move their eyes across a line of print without losing their place. Visual problems can interfere with learning and prevent children from performing to their full potential. Frustration and damage to self-esteem compound the problem.

        We can’t expect children to perform well in school if they don’t have the tools necessary for their ‘job’ of reading, writing, studying, taking notes and using a computer.

    Yet because the signs of vision problems are not well known, parents often only seek help once their child is functioning significantly below grade level. So often, because they’re relieved to finally have a cause diagnosed for the years of frustration, I hear parents say: “Why did no one find this sooner?”

    One in four children struggles with reading and school work because of undiagnosed vision problems. Every child deserves a comprehensive eye exam that includes a thorough evaluation of all tasks that directly affect one’s reading comfort and efficiency. Eye teaming, eye focusing and eye tracking, skills so crucial for good school performance, are, unfortunately, often not assessed when children are examined in preparation for school!

    When children have eye teaming or coordination problems, they may actually see double. A small misalignment of the eyes may rob children of the energy needed to concentrate and get meaning from what they read.  Difficulty with eye focusing skills means that a child may be unable to keep the print clear while reading. Children may also be challenged shifting their visual focus back and forth, near and far, when copying information from the blackboard.  Finally, a child's inability to appropriately track words while reading may also contribute to poor learning performance.

    Some vision problems can be resolved with special glasses to relax the eyes. Other vision problems only improve with vision therapy.

    Vision is learned; therefore, vision is trainable. If a child does not possess the necessary visual skills, he can be taught to acquire them through appropriate techniques. In a vision therapy program, we use instruments, special lenses and exercises to give feedback to the patient on whether his or her eyes are working correctly. This feedback guides the patient in “unlearning” poor seeing habits and in developing correct ones.

    Just as one learns to ride a bike or drive a car, in vision therapy the patient has to initially think about how he is using his eyes. In time, patients learn to see more quickly, accurately, and comfortably on a second-nature basis.

    Vision therapy is not only for children. Adults with vision-related disorders have often made career and life decisions based on how they best compensate for their undiagnosed vision problems. Motivated adults are perfect candidates for achieving excellent results.

    And what about all the adults whose work involves computers? Many suffer from headaches, refocusing symptoms, inefficient performance on the job, and/or a regular increase in their eyeglass prescription. These are all symptoms of the visual system trying to compensate for the tremendous demands we place on our eyes by constantly using them for near tasks. Of course, this applies just as well to children who spend hours in front of their computers, video games or books.

    When the visual system is functioning correctly, learning is enjoyable. The reader becomes free to think and learn instead of having to struggle with the reading process. Where books, school work and computers had been associated with headaches and discomfort, they can again become gateways to learning and accomplishment.

    In order to determine if one has a visual problem, a yearly evaluation that includes many tests at near-distances is really a must for any of us who use our eyes on a regular basis. Which reminds me….my mechanic told me that I should bring my car in for a full checkup at least once a year. All this attention to the care and upkeep of my car will, undoubtedly, entail an investment. But I am certain that it will save me much time and aggravation in the long run.   

DR. LUCHINS, optometric physician, specializes in Vision Therapy and Developmental Optometry. Her post-graduate work includes special education, cognitive psychology, ADHD and pediatric audiology.  She runs the Family Vision & Learning Center in Suffern, NY, which offers evaluation and treatment of Visual Efficiency and Visual Information Processing, learning difficulties, nearsightedness progression, and Computer Vision Syndrome.

Warning signs that a child might have a vision problem:

•    takes “hours” to do homework  
•    avoids reading
•    skips words or lines when reading   
•    slow reading
•    often overlooks or misreads short words  
•    holds book extremely close
•    poor concentration when reading   
•    rubs eyes, red eyes                                     
•    attention span shortens when doing intense close-up work  
•    has an increase in glasses prescription regularly
•    must use finger or marker to hold place while reading   
•    headaches or eyestrain with or after reading  
•    falls asleep or gets tired when reading, especially toward end of school day


   Does your child have ADHD? Avoid reading? Is s/he an underachiever? Learn about why some bright people study hard yet score poorly, why some are slow readers or take forever to do homework, vision conditions that mimic ADD/ADHD, and more. Dr. Michal Luchins is leading a seminar on Monday, February 4, for parents and professionals who work with children (educators, tutors, OTs, audiologists, social workers, psychologists, special education teachers and reading specialists). The free seminar runs 7:30-9pm, at Family Vision and Learning Center, 1 Executive Boulevard, Suite 105A, Suffern.
   For more information or to reserve a place, call or email VisionAndLearning@gmail.com. Info: 845-369-3235. www.optometrists.org/DrLuchins.