An undiagnosed vision issue could easily be mistaken for a learning disability. Does your child have an undiagnosed vision problem?

I’m thrilled to have pediatric OT and vision rehab specialist,  Robert Constantine, guest post for me today. Did you know that school vision screenings only detect 20-30% of vision problems?

Is it an undiagnosed Vision issue?

Vision is our furthest reaching sense. It tells us 75% of what we know about the world around us.

It affects movement, balance, and reading and writing ability.

But, vision is a frequently overlooked contributor to academic problems. Undiagnosed eye movement problems can mimic conditions like ADHD and dyslexia and are not identified on school screenings, making a complete vision exam a must for every child.

There are signs that a child may be having vision problems:

  • A child has difficulty with reading and writing even though they are receiving tutoring to improve these subjects.
  • Poor handwriting and letter reversals can be a sign of a binocular vision problem.
  • Frequent headaches and eye rubbing or tearing while reading or doing near vision tasks.
  • A child that is doing well in most subjects but struggles and dislikes reading tasks.
  • A child that fidgets, turns their head, or closes one eye during reading. They may also hold the pages close to their face or particularly far away while reading.
  • Motion sensitivity or disliking movement (like roller coasters), difficulty learning to ride a bike
  • Difficulty catching a ball
  • A child diagnosed with ADHD that does not respond to medication

But my child never said anything

It is very common for a child to have no visual complaints. This is the only way they have seen the world, so they are unaware that there is a problem.

They do not realize that seeing the words “get blurry and clear” or seeing the words “moving” on the page is not how we are all seeing. These are common symptoms of near vision focusing problems. The Convergence Insufficiency Symptom Survey is useful in helping to identify children that may have near vision focusing problems.

All eye exams are not created equal

In order to identify and properly diagnose an eye movement problem, the child will need a binocular vision exam. In this exam, the eye doctor will perform assessments like “near point of convergence” and a “measured cover” test.

Parents may have to ask if the office performs this service.

The complete pediatric eye exam will also include a cycloplegic dilation and refraction. This procedure will allow the doctor to get the most accurate prescription possible and thoroughly examine the health of the back of the eye. It is a necessary part of the complete eye exam.

When should my child get their eyes checked?

Most eye doctors agree that the first eye exam should be between 6 months and one year. The Infantsee Program provides this exam at no charge, with providers listed on the linked website.

The next exam is at 3 years old, then annually from 6-18 years old as vision changes, as the child grows.

Get to the Eye Doctor!

The visual system is very important in development and academic success. Every child should get a complete binocular vision exam to make sure they are reaching their full potential. What if an undiagnosed vision issue is an underlying reason for your child’s struggles in school?


About the Author:

Robert Constantine, OTR\L is an occupational therapist specializing in vision rehabilitation for nearly 5 years, following a career of 15 years working with stroke and brain injury patients. He now treats children that have eye movement problems and the functional problems associated with these eye movement problems. He also presents a continuing education course onvisual rehabilitation for pediatrics see in vision rehabilitation for pediatric patients hosted by Vyne Education. He has a blog focusing on vision issues and Facebook group “Pediatric Vision OT”. Visit his website here:  Vision Rehab OT – Robert Constantine


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