Is an eye exam at school enough?

A vision screening which is often done at the pediatrician's office or at school is NOT an eye exam. It is far from it. Parents often assume that these screenings are an eye examination. Here is why it is so important to get a child's eye examination.

Learning is 80% visual so you want to make sure your child has no vision issues. Simply seeing the board is not enough. According to the American Public Health Association, one in four children has undiagnosed eye problems which can interfere with learning and lead to academic and/or behavioral problems. However, it is important to know that these children frequently do not report symptoms because they think everyone sees the same way they do. Perhaps more alarming is that many of these children will pass a vision screening test, giving parents and educators a false sense of security that the visual system is normal and any difficulties experienced in school are not vision-related. The American Optometric Association estimates that vision screenings alone miss 25-30% of children with visual abnormalities. Many of these children are misdiagnosed with ADD or ADHD when in reality, they just have vision issues!

The problem with a pass/fail system based on 20/20 on a chart is that vision is so much more than just visual acuity! 20/20 eyesight determines how well we can see to drive or to see a whiteboard. It tells us if we can focus (at least temporarily) to see a book or a computer screen. But there are many things 20/20 eyesight will never tell us.

  • It will never tell us if your child:
  • Is able to consistently and comfortably see clearly all day long
  • Can focus back and forth to the whiteboard and book
  • Sees single rather than double
  • Can read without getting eyestrain or a headache
  • Can follow words on a page without losing his place
  • Can read without wanting to fall asleep
  • Has healthy eyes

Vision screenings typically measure vision without screening for hyperopia or farsightedness. Kids who are farsighted are able to use the focusing muscles of the eye to see 20/20 even though they may need glasses. This type of focusing (called accommodation) can temporarily provide vision clear enough to pass a screening, but it strains the visual system and is difficult to maintain in many learning-related activities. Farsightedness accounts for more learning-related vision issues than nearsightedness, making it a priority for optometrists to treat early.

Even if the school nurse or pediatrician is saying your child’s vision is fine, there are many more factors to check regarding the health of the eye.

  • Near and farsight – see if your child has an issue seeing at a distance or up close.
  • Focusing skills – can the eyes focus on items near and far
  • Binocular Vision/Fusion – do the eyes work together or do they drift apart? Is there eye coordination? If not, they may have Binocular Vision Dysfunction