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Home > Vision is more than seeing 20/20

Vision is more than seeing 20/20

Related Topics:

Amblyopia (lazy eye)

Visual Perception

Strabismus (eye turn)

RED FLAGS for Visual Problems

The Visual Connection to Dyslexia & Learning Disabilities

Vision: A Learning Connection

Aquired Brain Injury

Ready for School…but ready to learn?

As another school year rolls around I often wonder how many children come to school ready to learn? 

Most children are up to date on new school clothes, new backpacks, school supplies, and physical check-ups.

Many do not have one the most essential needs covered…a comprehensive eye examination from an eye doctor.

This is one of the most important “to-dos” and yet one that is often overlooked. In many states it is the law that a child have a vision exam with an eye doctor before registering for school.  Many children have vision problems that remain un-diagnosed, and often misdiagnosed as a learning disorder, ADHD, avoidance of near work or even behavior problems.

The idea that children need to be ready to learn—visually—is beginning to catch the attention of legislators.

Kentucky, Missouri, and Illinois have laws requiring mandatory eye examinations from a licensed eye doctor (not Lion's Club, pediatric or school screening) for children prior to entering school, and a federal bill has been introduced in the Senate. 

So what’s so important about having a comprehensive vision exam with an eye doctor? Why are vision screenings not enough? 

Consider that 80% of what your child’s brain processes comes through their primary sense…vision. 

Vision is a lot more than seeing 20/20. 

For example, vision involves eye muscles working together and holding a focus at near, like a fine motor task. Children with low muscle tone often have Convergence Insufficiency (CI).

CI is a condition where the visual muscles fatigue easily when focusing at near for reading, school work, or doing homework.   If a child has difficulty holding a pencil with the appropriate tripod grasp and open web space...or has difficulty doing buttons or tying their shoes...or slumps at their desk, then they often have difficulty with the fine muscle control required to converge their eye muscles to focus at near for very long periods of time in the classroom.  

Over 57% of school-age children have a vision disorder, many go undiagnosed because they have never had a comprehensive vision exam from an eye doctor. There are many visual conditions missed by screenings. 

While vision screenings can uncover some severe vision problems, they can miss many.   This is a major concern about vision screening programs.

They can create a false sense of security for those individuals who "pass" the screening, but who actually have a vision problem, thereby delaying further examination and treatment. 

While well intentioned, these individuals do not have the knowledge of an EYE DOCTOR who spends 4-8 years studying vision.

There is often a misunderstanding about what passing a vision screening means. The information obtained from a vision screening can be compared to the information obtained from a blood pressure measurement. Because your blood pressure may be in normal range, it cannot indicate that you do not have other health problems. It provides a single measure of one aspect of your overall health. Just like a complete physical is needed to evaluate total health, only a comprehensive eye and vision examination can evaluate your overall eye health and vision status.

A comprehensive vision examination can only be conducted by an optometrist or ophthalmologist, who has the specialized training needed to make a definitive diagnosis and prescribe treatment.  If your child has a learning disorder or special needs, make sure to see an eye doctor who has a fellowship in vision development (F.C.O.V.D. behind their doctorate name). 


Frequency of Comprehensive Vision Examination by Eye Doctor


- - - - - - Examination Interval - - - - - -


Patient Age


At Risk

Birth to 24 Months

At 6 months of age

At 6 months of age or as recommended

2 to 5 years

At 3 years of age

At 3 years of age or as recommended

6 to 18 years

Before first grade and every two years thereafter

Annually or as recommended

18 to 60 years

Every two years

Every one to two years or as recommended

61 and older


Annually or as recommended

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