Undetected and untreated vision conditions can act as barriers to learning and healthy childhood development. When a child is visually ready to learn, that child will succeed, not just in the classroom, but in life. Studies indicate that:
- Nearly 75% of the school day is spent in visual activities.
- Vision disorders are the fourth most common disability in the United States.
- Between 17 and 25% of school age children have undetected and treatable vision problems that can interfere with learning.
- 1 out of 5 children entering kindergarten have undetected vision problems that may hinder their ability to learn.
- More than 80% of what we learn is through visual processing.
- Vision deficiencies in school age children are often misidentified as behavior or social problems, which sometimes puts a child into the wrong “treatment track” (often at taxpayer’s expense).
- More than 75% of juvenile offenders have undetected and untreated vision problems.
- Functional illiteracy among minority youths may run as high as 40%.
Definitions of Vision Testing
Vision Screening Test
A test that is used to make general categorizations of examinees (i.e. students). Vision screenings typically test only for distance vision. Vision screenings are performed by school nurses. In many instances volunteers also perform vision screening tests. Equipment called “vision screeners” maybe used for the testing and run by the volunteers and/or school personnel. Vision screening tests are a valuable component to vision care but should not be thought of as a comprehensive vision examination.
A vision assessment is a systematic method of obtaining evidence from a series of defined tests that is used to draw inferences about the health and function of the visual system. “See To Learn” is an example of a vision assessment available free of charge from a “See To Learn” provider for every three year old in the state of Nebraska. Vision assessments are valuable to determine a child’s possible problems with visual health and function but vision assessments do not replace comprehensive vision examination.
School Vision Evaluation
All students new to Nebraska schools are required by law to receive a vision evaluation. This evaluation consists of requirements to examine specific components of a student’s visual system: Amblyopia (lazy eye), strabismus(misalignment of the eyes), internal and external health of the eye, and visual acuity. The vision evaluation must be performed by an optometrist (OD), physician (MD), a physician assistant (PA), or an advanced practice registered nurse(APRN).
The school required vision evaluation is important to insure that all students entering Nebraska schools for the first time are prepared to learn. However, the testing and observation components are not complete enough to be considered a comprehensive vision evaluation.
A Comprehensive Vision Examination is a series of tests and observations that measure the health and function of an individual’s visual system. A comprehensive vision evaluation can only be performed by law within the scope of practice by an optometrist (OD) or ophthalmologist (MD).
Exam and Screening Comparisons
The Elements of a Comprehensive Eye Health Exam and Vision Analysis The American Optometric Association (AOA) recommends the following information be gathered and tests be performed during a comprehensive eye examination:
- Chief Complaint: assessment of the patient’s reason for getting an eye exam.
- General Physical Health History: complete health history to screen for physical conditions and medications that may affect eyesight.
- General Ocular Health History: complete eye health history including family history of eye conditions, disease, or medication.
- External and Internal Eye Health Evaluation: examination for the signs of eye disorders, including cataracts and other eye disorders.
- Current Prescription Analysis: evaluation of current lens prescription, if applicable.
- Visual Acuity: test for the eyes’ ability to see sharply and clearly at all distances.
- Refraction: test for the eyes’ ability to focus light rays properly on the retina at distances and close by.
- Tonometry: test to measure internal fluid pressure of the eye (increased pressure may be an early sign or glaucoma).
- Visual Coordination: check for external eye muscle balance and coordination.
- Accommodative Ability: test of the eyes’ ability to change focus from distance to near. An exam may also include tests for color vision and depth perception, visual fields, and other vision skills, as needed.
Children’s Eye Exam
Children should receive their first eye exam at the age of six months, then again when the child turns three. Subsequent exams should be given before the child starts school, then every two years after that. Based on family history or other indicators, your eye care professional may recommend a more frequent exam schedule.
Many eye disorders, including hyperopia (farsightedness), myopia (nearsightedness), and amblyopia (lazy eye) can occur in early childhood, and may affect your child’s ability to learn. A comprehensive eye exam can detect these and other disorders.
In between eye exams, you can take an active role in monitoring your child’s vision. For instance, regularly ask your child to describe the way he or she sees objects up close or at a distance (across a room or street).
The child may not realize if his or her vision is not clear and sharp.
Additionally, look for the following signs that your child may have vision problems:
- one or both eyes turning in, out, up, or down
- head turn or head tilt
- inability to copy notes from a blackboard
- reversals of words or letters
- frequent rubbing of eyes or tearing
- eye redness or crusting of eye lids/lashes
- eye pain
- disinterested in close work, such as coloring or reading
- sitting very close to the television (indicating that he/she can’t see if made to move back)