Most children have normal sight, which involves seeing well on an eye chart at a distance, but many children have (often undetected) problems with vision involving focusing, eye coordination, convergence, and eye movements, for reading and writing tasks at near.
Unfortunately, if a child is tested only on a distance eye chart they may be wrongly assumed to have normal vision for reading and writing up close, but often this is not the full story.
Problems with focusing and eye coordination can significantly interfere with the child’s ability to use their eyes to read fluently and accurately.
How Common Are Problems?
Research has shown there are strong connections between problems of visual function, visual perception , and learning. A recent study by researchers from the Queensland University of Technology Faculty of Education, published in the International Journal of Education Research, looked at vision screening of Grade 3 children in Australia. Approximately 30% of the children tested were identified as borderline or unsatisfactory by a vision screening.
Children found to have vision problems scored significantly lower on NAPLAN tests of reading, grammar and punctuation, spelling and numeracy, when compared to their not-referred peers. In the majority of cases children were referred for comprehensive vision examinations because of binocular vision problems (poor eye coordination), focusing errors, or a combination of the two, which can all affect a child’s visual efficiency, and ability to achieve comfortable, clear, single vision for reading.
Medical specialists and other eye care professionals recommend the following for children:
An ophthalmologist, pediatrician, family doctor or other trained health professional should examine a newborn baby’s eyes and perform a red reflex test (a basic indicator that the eyes are normal).
A second screening for eye health should be done by an ophthalmologist, optometrist, pediatrician, family doctor or other trained health professional at a well-child exam between six months and the first birthday.
Between the ages of 3 and 3½, a child’s vision and eye alignment should be assessed by an ophthalmologist, optometrist, orthoptist or person trained in vision assessment of preschool children. Visual acuity should be tested as soon as the child is old enough to cooperate with an eye exam using an eye chart. If misaligned eyes (strabismus), "lazy eye” (amblyopia), refractive errors (myopia, hyperopia, astigmatism) or another focusing problem is suspected in the initial screening, the child should have a comprehensive exam by a professional trainined to manage these problems. It’s important to begin treatment as soon as possible to ensure successful vision correction and life-long benefits.
Upon entering school, or whenever a problem is suspected, children’s eyes should be screened for visual acuity and alignment by an optometrist, ophthalmologist, pediatrician, family doctor, or orthoptist. Nearsightedness (myopia) is the most common refractive error in this age group and can be corrected with eyeglasses. If an alignment problem or other eye health issues is suspected, the child should have a comprehensive examination.
Eminent Australian ophthalmologist Professor Frank Martin provides excellent advice, “If you are concerned about anything to do with your child’s eyes or eyesight, seek help from an eye health professional. It is never too early to have your child’s eyes assessed, and it is important that a child has their eyesight checked prior to starting school”
Recommended Eye Examinations
1. Shin HS et al. Relationship between accommodative and vergence dysfunctions and academic achievement for primary school children. Ophthalmic and Physiological Optics 2009;29:615-624.
2. White SLJ, Wood JM et al. Vision screening outcomes of Grade 3 children in Australia: Differences in academic achievement. International Journal of Educational Research 2017;83:154–159.