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As children with undetected vision problems continue year after year, frustration with academic activities can be observed in behavior. 

Some of these are avoidance behaviors:

• Can read, but chooses not to

• Short attention span

• Confrontation with authority

• Behavior problems

• Labeled as lazy or not motivated

The majority of children who struggle in school are said to be smart, engaged and hard workers. So why aren't they academically successful? There are a variety of causes, one of the most common is an undetected vision problem.

80% of learning is visual, which is one of the reasons undetected vision problems can make learning more difficult. Vision problems often times go undetected because many of the symptoms are not recognized as being associated with vision. Some common symptoms that educators and parents will observe in the classroom or while reading are:

• Lip reading or whispering

• Turning or tilting of the head

• Covering or closing one eye

• Difficulty copying from the white board to paper

• Laying the head on an arm in order to block one eye

• Writing uphill or downhill

• Moving the head back and forth across the page, rather than the eyes

• Mistakes words with similar beginnings

• Loses place on the page

• Poor eye-hand coordination

• Rereads or skips words

• Uses a finger or marker to keep place

• Omits letters or words

• Writing is difficult to read, crowded, shifted to one side of the page, or inconsistent in size

• Misaligns numbers or letters in columns

• Headaches

• Excessive blinking or watering of the eyes

Children with undetected vision problems can become frustrated over time. They see that classmates can keep up with classroom assignments, easily completing them within the time allowed. While they spend an inordinate amount of time studying, yet find they cannot recall the information as quickly as required for the tests. They struggle with reading fluency and reading comprehension. What is a parent to do?

Many parents, and educators, assume that working with a reading specialist or enlisting the help of a tutor will “turn things around”. For some children this is like being asked to run in a relay with a sprained ankle. They can run the relay; but they will have a very difficult time and have a much slower time than their teammates. The sprained ankle needs to be addressed before they can run the relay at their personal best. The same is true when it comes to reading. They can read; but they are going to have a very difficult time, with poorer fluency and comprehension than their classmates. The undetected vision problem must be identified and corrected before they can read at their personal best.

As children with undetected vision problems continue year after year, frustration with academic activities can be observed in behavior. Some of these are avoidance behaviors:

• Can read, but chooses not to

• Short attention span

• Confrontation with authority

• Behavior problems

• Labeled as lazy or not motivated

Some children also avoid visual tasks by becoming better auditory learners; or excel in social, verbal and athletic activities. Keep in mind, performance my be inconsistent or selective in nature.

Children may also adopt postural changes in the classroom or while reading or completing homework assignments. These postural changes can include:

• Shifting in the seat

• Moving from side to side

• Raising and lowering the body

• Covering one eye

• Holding reading material unusually close

• Moving the head, rather than eyes, across the page

Postural changes are an effort to compensate for binocular vision problems such as focus or eye-teaming deficits.

In addition to deficits in visual acuity, eye teaming, eye tracking, focusing, depth perception, etc.; visual perception and visual information processing also affect academic performance. Visual perceptual skills are the ability to organize and interpret the information that is seen and give it meaning. Information processing skills include:

• Form discrimination: ability to recognize similarities and differences in size, shape, pattern, form, position and color.

• Spatial relations: ability to judge the relative position of one object to another

• Figure ground: ability to locate a figure or shape in a busy background

• Visual closure: ability to identify or recognize a symbol or object without seeing the whole object

• Form constancy: ability to recognize symbols and figures even when they are made larger, smaller or turned a different direction

• Visual memory: ability to remember forms (numbers and letters) and sequences of forms (words)

It is estimated that one of every six children is two or more grade levels behind in reading. Often times the feeling is that perhaps it is the teacher. Or perhaps it is age, and the child will outgrow the problem. Maybe a different school would be better. Perhaps the work is too hard for the grade level. While this may be true from time to time, it is also a good idea to find out what specifically may be causing the struggles in school.

An easy first step is to have a comprehensive eye exam with a residency trained pediatric eye doctor. An eye doctor who has been formally trained in the vision conditions affecting the pediatric population. Do your research, and don't settle for a general optometrist if your child is struggling in school. Be aware that some general optometrists advertise that they specialize in pediatrics. When you call to schedule an eye exam be sure to ask:

• Where did the doctor complete his/her pediatric residency?

• Does the doctor dilate children during an eye exam?

• If so, what type of dilating drops does the doctor use?

• Does the eye doctor test for binocular vision dysfunction?

A pediatric eye doctor will have completed an accredited academic pediatric residency program; will dilate children during an eye exam; and will use cycloplegic dilating drops. Only schedule an eye exam for your child if the eye doctor is trained in pediatrics. This is especially important if your child is having difficulties in school.

There is no reason your child has to be part of the statistic: 1 in 4 children (25%) have an undetected vision problem. The rate may be as high as 60% for children with learning difficulties. Does your child have an undetected vision problem? There's only one way to know. Call 208.377.8899 to schedule an eye examination with Jill A. Kronberg, OD, FAAO.