What School Eye Exams Don't Pick Up


Regular Eye Exams are Important to Your Child's Health   School is now in session. Every parent's back-to-school checklist surely included pencils, knapsacks, and a visit to the pediatrician. But did it include a trip to the eye doctor?

   Eighty percent of learning is through the visual system. So surely an eye exam should be at the top of the back-to-school list. Yet a recent survey showed that 76 percent of children below the age of 5 have never had a comprehensive eye exam with an eye doctor!

   Most parents rely on school and pediatrician vision screenings, assuming these to be eye exams. But that's like having your blood pressure checked in place of a complete physical examination. Unlike a thorough eye exam, a standard vision screening using just an eye chart identifies about five percent of vision problems in children. 

   Vision screenings only check a child's distance vision, that is, her ability to see well at 20 feet away. Yet the child's ability to see well up close, such as while reading a book or using the computer - so very critical for good performance in the classroom - is rarely assessed in screenings.

   Furthermore, an eye chart also 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.

   When children have eye teaming or coordination problems, they may actually see double. A small misalignment of the two 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. A child's inability to appropriately track words while reading may also contribute to poor learning performance. One of the most common vision problems experienced by children is being farsighted. Farsighted kids can usually see the blackboard fine, but get tired when they read up close. 

   It is important to understand that only an eye doctor can perform eye tests that can detect and rule out conditions such as glaucoma, tumors, lazy eye, and mild farsightedness. In addition, conditions that are becoming increasingly prevalent in children, such as diabetes and high blood pressure and cholesterol, can be detected in the eye - by an eye doctor - long before other symptoms of these serious conditions are evident elsewhere in the body.

   And what of the many hours children now sit in front of computers and videogames? Children spend an average of four or more hours a day engaged in these activities, which strain the eye and can lead to Computer Vision Syndrome (CVS) in children just as in adults. CVS is a serious vision issue that can cause many symptoms, including any of the following: blurred vision, headaches, sleepiness, nearsightedness, and neck and shoulder pain.

   Another concern in regard to children's vision is sun protection - or lack thereof. While 68 percent of adults wear sunglasses outdoors, fewer than 30 percent of children do so.

   It would seem that most adults give better protection to their own eyes than to their children's eyes. Vision problems can be ruled out with a thorough eye exam by a pediatric eye doctor. Visit www.COVD.org to find a doctor near you and www.children-special-needs.org/parenting/preschool/pediatric_eye_exams.html to learn details of what a comprehensive, pediatric eye exam includes.

   Here are some tips for keeping your whole family's eyes healthy.

1. Start eye exams early. A child's first eye exam should be at 6 months of age, and he should see the eye doctor again between ages 3 and 5. Yearly eye exams are needed thereafter (unless more frequent visits are specifically indicated).

2. Look for signs of hidden vision problems. Do not expect children to come to you and tell you what their visual symptoms are. Children only have one set of eyes and have never seen differently. Even those who are walking around seeing double or cannot clearly see the words in their books rarely complain. Be on the alert for headaches, poor eye-hand coordination, a dislike of reading, excessive rubbing of the eyes, sensory integration dysfunction, reading problems, or difficulty focusing, paying attention, or sitting still - especially when reading. Any of these common symptoms could indicate vision problems

3. Encourage "visual hygiene." Make sure books and videogames are never closer to the eye than an arm's length. The computer, as well, should not be too close; 18-22 inches is usually a comfortable distance, depending on the size of the screen and other variables. Also take frequent breaks while reading, studying, playing videogames, or on the computer. A one-minute break every 15 minutes is ideal, but never spend more than 30 minutes at a time before taking a break. This break should be spent giving the eyes a good "stretch" by alternately looking at something about 20 feet away and something nearby.

4. Use computer glasses if needed. Behavioral developmental optometrists (eye doctor specialists) can prescribe glasses specifically for computer use that can help lessen the symptoms of CVS.

5. Schedule annual appointments at the eye doctor. One in four children struggle with reading and schoolwork because of undiagnosed vision problems. Every child deserves a comprehensive eye exam, one that includes a thorough evaluation of all tasks that directly affect reading comfort and efficiency. When you book your child's annual (or perhaps biannual) appointment with the dentist, remember to book the eye doctor appointment, too.

DR. MICHAL LUCHINS' practice, Family Vision & Learning Center, is in Suffern, NY. For more info: www.optometrists.org/DrLuchins.