Delinquent Eyes

According to the Prevent Blindness America organization, vision problems affect 25% of school-aged children. And these vision problems can prevent a child from achieving their academic potential. Many teachers may find it hard to believe that 25% of their students have a visual barrier to success because they don't see a quarter of their students wearing glasses. The reason for this difference is that many of the vision conditions affecting students are not treated with glasses.

Many students see 20/20 on the eye chart, but have difficulties with binocular vision (eye teaming), accommodation (eye focusing), ocular motility (eye tracking) or visual perception (interpreting visual information). Deficit in these areas are often missed during a vision screening or basic eye exam and unfortunately can have a tremendous impact on a child.

More than 80% of classroom learning occurs through the visual system, which is why an undiagnosed vision problem can have such a profound impact on a child's academic success. A child's experience in school has an equally profound impact on their course in life. We all have a teacher that helped shape us and that we remember to this day. Many people who now teach can even name a teacher from their past that influenced their decision to pursue education as a career. Unfortunately, a negative experience in school can also influence a child's adult life in a negative way. A study performed in 2000 found that a significant number of children in the juvenile court system had significant vision problems. Other studies, including one by the United States Department of Education, found that 75% of illiterate adults in the study failed one or more areas of the vision test. Eye tracking was one of the most common skills failed on the test.

If a visual barrier to success exists, it is important to diagnose and treat the condition before it impacts the child's success. The testing necessary to diagnose these vision conditions is not performed during a vision screening, such as the one performed at school or the pediatrician's office, and is often not performed at an eye exam designed to prescribe glasses. In order to identify these vision conditions a developmental eye examination must be performed that evaluates not only the prescription and eye health of the child, but also includes assessments of the visual skills that are used in the classroom.

An optometrist who is residency-trained in either pediatrics or binocular vision is able to diagnose and manage these vision conditions. Following a comprehensive eye examination with a pediatric optometrist, a Binocular Vision Assessment may be recommended to evaluate binocular vision (eye teaming), accommodation (eye focusing), oculomtor function (eye tracking), visual perception, visual processing speed and visual working memory.


The vision conditions that can impact academic performance do not always affect a child's ability to see 20/20 on the eye chart. For this reason a child may pass a screening but still have visual struggles. Parents and educators should look for the sometimes subtle symptoms of a vision problem affecting classroom performance. These signs and symptoms include:

• Difficulties with reading fluency (skipping lines or words, mistaking words for similar beginnings, difficulties with site word recognition) or comprehension

• Covering or closing one eye while reading

• Eyestrain (sore, hurt, pulling sensation, or eye fatigue)

• Headaches (especially at the end of the day)

• Double vision (even occasional)

• Words appearing to float, move or swim on the page

• Difficulties taking notes from the board

• Poor concentration during visual tasks

• Variable performance or poor performance with fatigue (at end of day)

It is important to know that many of the vision conditions that impact a child's ability to learn from visually-presented material do not respond to glasses and do not require surgery. If the Binocular Vision Assessment leads to a diagnosed vision condition, such as convergence insufficiency, accommodative dysfunciton or oculomotor dysfunction, the doctor will recommend in-office vision therapy to successfully treat the vision condition.