By Miriam Longobardi
If you thought vision screening for your child was only for accuracy, think again. What we see is determined by our brain’s interpretation and processing of information and there are a number of connections between learning and vision. Dr. Janet Woo, an optometrist with Eye Designs of Armonk, and Dr. Carolyn Lederman, an ophthalmologist with Lederman and Lederman, LLP in Purchase, shared some of the impact visual processing and other issues can have on learning, as well as some common warning signs your child may well be experiencing vision problems.
According to Dr. Woo, “As young children acquire language, they tend to visualize images associated with people, colors and objects. Visual memory helps them recall something that they have been asked to retrieve or, as in reading, parts of a story. Children with poor visual memory tend to struggle with recall and multistep directions.” As an elementary teacher I see this type of behavior often. For example, if students are directed to go and take out their homework planner, a highlighter and red notebook, they may only remember one or two of those directions. Another common processing issue is visual closure. In other words, if an adult is shown a picture with parts missing or a word with letters missing, the brain takes over and fills in these gaps. Children who struggle with closure need to be taught other strategies to do this.
Other common visual processing issues I have seen amongst students are reversals of letters and numbers, color blindness and difficulty tracking without using a finger while reading. Some children skip entire words or lines of a book which leads to gaps in reading comprehension. Dr. Woo noted that many children experience double-vision when their eye muscles are fatigued but think that is normal so do not report it. They may abandon books or stop watching a movie and claim they are bored or tired when in fact eye fatigue is the cause.
Dr. Lederman agrees that vision issues may go undetected in children. “A child does not complain because he or she does not know what normal vision is. Good vision is essential for proper learning in school. Children who cannot see well may not be able to participate in class and may be distracted or withdrawn. Children, parents and teachers are often unaware of a child’s visual difficulties. Parents and teachers are frustrated by a child’s lack of progress which may resolve after a comprehensive eye exam uncovers a problem and treatment is initiated.” Lederman notes that while vision problems are not the cause of primary dyslexia or other learning disabilities, any child who isn’t reading at grade level or is suspected to have or has been diagnosed with a learning disability should have a comprehensive ocular exam.
Another concern Dr. Woo reports is that eye strain due to screen exposure is hazardous. “I recommend no more than 30 minutes at a time of looking at a screen, whether phone, computer or video game,” she said.
Dr. Lederman cautions parents and teachers to note warning signs in children. “Squinting, blinking or face turning may indicate a vision problem, as can holding books close or moving closer to the board or television. If the eyes don’t seem aligned (both eyes looking at the same thing at the same time), a child should be examined immediately. Normal ocular alignment is critical. If a child closes one eye when reading or comments on double vision, he or she should be examined.”
Headaches may also be an indicator.
Early detection of vision problems is a key part of treatment. Tracy M., a Mount Kisco mother of three, was told by her pediatrician that her youngest daughter, Maggie, may have amblyopia, commonly termed, “lazy eye,” and was referred to a pediatric ophthalmologist. This was at Maggie’s 18-month-old well check-up. The ophthalmologist confirmed the diagnosis, and prescribed a patch to be worn three hours a day on the dominant eye as well as glasses. The patch was used for another five years. Tracy herself was diagnosed with the same condition (but not until she was age five), and recalls wearing an eye patch. “Nowadays they have patches with all sorts of cute designs on them for kids. Maggie would even decorate her own patches.” Maggie continues to wear corrective lenses and her eyes are now able to work together.
So what tests and screenings should typical children have? According to Dr. Lederman, “The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and the American Academy of Pediatrics (AAP) have designed a screening schedule for all children from birth through school years. Children as young as three years old should have their vision checked at their annual well visit examination; newer devices assess visual development even in pre-verbal children. School nurses assess vision and ocular alignment when students are entering kindergarten and periodically during a child’s years in school. Some test color vision and depth perception. If any abnormalities are suspected as well, a child should have a comprehensive ocular examination.”
Miriam Longobardi is a freelance writer, fourth grade teacher and single mother of two daughters living in Westchester. A breast cancer survivor, she volunteers for the American Cancer Society, has completed four marathons and travels the world. Follow her on Twitter@writerMimiLong.com.