Alamo Optometry Blog

September 7, 2014

School and Children’s Vision

Filed under: Children's Vision — gkblog @ 5:39 pm

(As appeared in Alamo Today, September, 2014)

It is hard to believe that most of summer vacation is behind us and school is back is session.  August and September are usually the months where most parents prep their children for the upcoming school year.  The list usually includes school supplies, clothes, backpacks, etc. and yearly physicals are done with their pediatrician to ensure a healthy start to the year.  Even though most of you realize the importance of vision and eye health, it is vitally important for your child to be able to see well at all distances and have good eye-teaming skills to be able to learn and prosper at school.  I will cover some of the main eye issues related to difficulty at school.

I would say the most common diagnosis I find at the office is myopia, or near-sightedness.  For students that sit far away from the board or in the back of a large lecture hall, having uncorrected or under-corrected myopia will lead to blurry vision and an inability to see the material on the board, screen, or overhead.  I have found it common for younger children with this situation to have classroom issues in addition to lower grades due to the fact that they tend to be disruptive in class because they can’t see clearly more than a few feet in front of them.  These students are unable to take notes off of the board and therefore often fall behind in class and miss assignments.

At the opposite end of myopia is hyperopia, or far-sightedness.  These students are in a constant state of focusing to allow clear vision.  The closer the point of focus the more work that is necessary to clear the image.  That is why distance objects are easier than near ones.  A low amount of hyperopia is actually desirable, since near-sightedness tends to evolve as the child enters adolescence, so it gives them a little head start.  However, in larger prescriptions, hyperopia can cause near avoidance, headaches, fatigue, eye turns, and an overall indifference to sustained up-close tasks.  This can easily be diagnosed in the office as part of a comprehensive examination.

The last prescription issue that can be a hindrance to vision is astigmatism.  This is caused by the cornea, the clear front surface of the eye, not being completely round.  An easy analogy is that it is shaped more like an egg than a ball.  Astigmatism will generally degrade both distance and near vision; however, distance is usually a little more affected.  It is important to note that this is not a disease; it is just the way the eye is shaped and can be treated with glasses or contact lenses just like myopia and hyperopia.

In addition to having a prescription, all patients including children should have their binocular vision status evaluated.  It is quite possible to not have any of the above-mentioned prescription issues, but have poor eye teaming skills.  If the eyes are not aligned properly and do not work well as a team, there will be learning and reading issues.  These tend to present themselves more for reading than distance, but can definitely affect both.  When the eyes do not work as a unit, a child might experience double vision, “stretching” or “ghost images” of letters, skipping of letters or lines of text, eyestrain, headaches, near avoidance, or any combination of these.  Depending on the exact diagnosis, the condition can be treated with glasses or vision therapy.

I recommend having your child’s vision checked by an eye care professional instead of just relying on a school or pediatrician screening.  Most children that need to be evaluated are generally picked up by these screenings, but the comprehensive evaluation I give at the office not only encompasses vision and binocular vision, but also includes neurological testing, color vision, peripheral vision, and an ocular health examination of both the front and back portions of the eye.  We look forward to seeing your students in the office soon.

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