Why is a yearly eye exam as well as a visual skills exam potentially so important for students as they enter a new school year? Over the next couple of weeks we will look at well-designed clinical studies to help us understand the importance of vision, which includes eyesight and visual skills, in learning.
We will start with this recent finding. In a study involving students who werealready diagnosed with a visual skills problem, their top 5 most frequent complaints were:
loss of place while reading
needing to re-read
loss of concentration
trouble remembering what was read.
Does your child exhibit any of those five symptoms? If so, then maybe it’s due to an undiagnosed visual skills problem. A yearly exam is a good place to start, but yearly eye exams do not check for the visual skills problems that can cause those symptoms. Schedule a visual skills exam in addition to the yearly eye exam.
Yet another reason to try to slow down how quickly nearsightedness increases is the risk of retinal detachments. Myopia, or nearsightedness, increases the risk of a retinal detachment by 4X-16X’s; the higher the prescription, the higher the risk. The retina is the tissue in the back of the eye that contains all of the nerves, cells and blood vessels that help you see. Surgery can be performed for retinal detachments. However, clinical studies show that patients who have had retinal detachment surgery complain about lower quality of life afterwards. In other words, the surgery was physically successful. However, the patients still suffered decreased quality of life due to visual difficulties afterwards.
Another reason to slow down the progression of nearsightedness is the increased risk of glaucoma. Nearsightedness, or myopia, increases the risk of glaucoma by 4x’s. Glaucoma slowly kills the nerves in the eyes, and is a leading cause of blindness. If someone develops glaucoma, he won’t even notice any changes in how he sees until 30%-50% of the nerves have already died.
Amblyopia is the most common cause of childhood vision loss. Proper diagnosis of the type of amblyopia is crucial for prognosis and treatment. Oftentimes, the first step in treating amblyopia is glasses. However, some children will not accept the prescription initially because of how their visual system is locked into working. Appropriate identification and medicinal management of these children to improve their acceptance of the treatment is vital in overcoming amblyopia.
If a child passes vision screenings with only the bare minimum requirement of 20/30 eyesight, then there will be long-range consequences. For example, the child’s reaction speed on the road once they start driving would be 16x’s slower than what it would have been had they developed 20/20 eyesight. Vision screenings are important, and seeing 20/30 is pretty good. However, seeing 20/20 is even better, and an actual eye exam can help your child develop the optimal eyesight that they need in life.
Passing a vision screening at school or the pediatrician’s office only requires 20/30 eyesight at distance. If a child never develops better than 20/30 eyesight, then the student will have a difficult time comfortably seeing 8th grade level text later. Vision screenings are important, but actual eye exams are more thorough and even more important. More on this later.
1 in 10 children suffer from a vision problem that affects academics. School and pediatrician screenings only check for the ability to see the board clearly. However, 80% of learning occurs through the eyes, and screenings only check one small part of vision. For example, undetected farsightedness, undetected astigmatism, poor eye-focusing skills, inaccurate eye coordination skills and imprecise fine eye movements can all contribute to reading difficulties. If your child is struggling with school, take time out to check her vision. Start first with a yearly eye exam, and then if necessary, schedule a full-fledged visual skills exam that will evaluate the entire visual system and how it may be affecting your child.
Vision training improves concussion symptoms in up to 90% of cases according to research. Headaches, blurred vision, double vision, dizziness, balance problems, light and noise sensitivity, eye fatigue, and loss of place with reading and close work are common visual symptoms after a concussion. We have helped a number of people with these symptoms. If you know of someone who is suffering from the effects of a concussion, please let them know that we can help.
Astigmatism as little as 0.50 diopters negatively affects preschool academic readiness. In a study involving preschool children between the ages of 3 years and 5 years, children with astigmatism consistently performed lower than their peers without astigmatism in Language and Literacy, Physical Health and Development and Communication as measured by the teacher-reported Work Sampling System (WSS) and the parent-reported Ages and Stages Questionnaire (ASQ). The WSS correlates well with the Woodcock-Johnson Psychoeducational Battery Revised.
Children with small amounts of astigmatism are easily missed during vision screenings at school or the pediatrician’s office. An astigmatism magnitude of 1.50 diopters would be needed before a child even meets the 20/40 pass-fail criterion for referrals, but as little as 0.50 affects school readiness. Unfortunately, forty percent of children, even if they fail the screening, do not follow up with an eye doctor. The statistics are even worse for younger children – only 7.5% of children younger than six years of age visit an eye doctor.
There are other visual skills that can affect academics besides the need for a prescription. Refractive error, though, is an important contributor to school readiness. Even small amounts of astigmatism have been shown to affect development. Have your child’s refractive status thoroughly checked to make sure that he/she is as ready to succeed in school as possible.
1. Orlansky G, Wilmer J, et. al. Astigmatism and early academic readiness in preschool children. Optom Vis Sci, 2015; 92(3): ahead of printing.
2. Moon BY, Kim Sy, et. al. Predicting of astigmatism from decimal visual acuity in spherical equivalent. J Op Sci Kor, 2013; 17(2):219-223.
3. Centers for Disease Control and Prevention. Visual impairment and use of eye-care services and protective eyewear among children – United States, 2002. MMWR 2005; 54:425-429.