Is an Eye Exam at School Enough?

A vision screening, often conducted at the pediatrician's office or at school, is NOT the same as a comprehensive eye exam. It is far from it. Parents often assume that these screenings are sufficient, but here’s why it’s so important to ensure your child receives a full eye examination.

Learning is 80% visual, so it’s crucial to make sure your child has no vision issues. Simply being able to see the board is not enough. According to the American Public Health Association, one in four children has undiagnosed eye problems that can interfere with learning and lead to academic and/or behavioral problems. However, many of these children do not report symptoms because they assume everyone sees the same way they do. Perhaps more alarming is that many of these children will pass a vision screening test, giving parents and educators a false sense of security that their visual system is normal and that any difficulties experienced in school are not vision-related. The American Optometric Association estimates that vision screenings alone miss 25-30% of children with visual abnormalities. Many of these children are misdiagnosed with ADD or ADHD when, in reality, they have vision issues!

The Problem with a Pass/Fail System

The problem with a pass/fail system based on 20/20 vision on a chart is that vision is so much more than just visual acuity. 20/20 eyesight determines how well we can see to drive or to read a whiteboard. It tells us if we can focus (at least temporarily) to see a book or a computer screen. But there are many things 20/20 eyesight will never tell us.

• It will never tell us if your child is able to consistently and comfortably see clearly all day long.
• It will never tell us if your child can focus back and forth between the whiteboard and a book.
• It will never tell us if your child sees single rather than double.
• It will never tell us if your child can read without getting eyestrain or a headache.
• It will never tell us if your child can follow words on a page without losing their place.
• It will never tell us if your child can read without feeling the need to fall asleep.
• It will never tell us if your child has healthy eyes.

Why Vision Screenings Aren't Enough

Vision screenings typically measure vision without screening for hyperopia or farsightedness. Children who are farsighted can use the focusing muscles of the eye to see 20/20, even though they may need glasses. This type of focusing (called accommodation) can temporarily provide vision clear enough to pass a screening, but it strains the visual system and is difficult to maintain during many learning-related activities. Farsightedness accounts for more learning-related vision issues than nearsightedness, making it a priority for optometrists to treat early.

Even if the school nurse or pediatrician says your child’s vision is fine, there are many more factors to consider regarding the health of their eyes.

• Near and farsight – Can your child see clearly at a distance or up close?
• Focusing skills – Can the eyes focus on items near and far?
• Binocular Vision/Fusion – Do the eyes work together, or do they drift apart? Is there eye coordination? If not, your child may have Binocular Vision Dysfunction.