Why Your Child Should Have A Real Vision Examination
Dr. Ernest V. Loewenstein, O.D. Ph.D.

Most children get some kind of eye test at school or at the pediatrician's office. And most parents believe that if nothing is said about the need for further attention, all is well with the child's vision. Not so.

• The school eye test consists of asking the child to read an eye chart at twenty feet. Hence, the designation 20/20. (Occasionally, a test of eye coordination is added.) A passing grade on the chart test means that the child can probably see the blackboard at the front of the room with at least one eye.

• Notice that we've used the words eye test, not eye exam or vision exam. Vision is multi-dimensional. It cannot be evaluated just by reading a chart. A temperature of 98.6 degrees doesn't indicate your health is good. It's simply one measurement out of the several typically taken. 20/20 on a chart test doesn't mean a child's vision is ready to meet the challenges of school. The critical tests of vision at near distances are rarely done on children.

• The primary task of the child and adolescent is learning, first by observing and then by reading. A good 80% of what is learned is acquired visually. To do this efficiently the child
  • must have good control of the eye movements,
  • must be able to focus clearly at the distance of the book (12-20 inches, not 20 feet),
  • must be able to coordinate the movement and focus of the two eyes, and
  • must be able to sustain this kind of visual activity for the duration of whatever task is presented, reading, arithmetic, or computer use.

If the visual system is not working smoothly, the child is distracted from the learning.

• Some serious eye conditions are not readily detected by the eye test or screening. An eye that does not see well because of astigmatism or because it does not coordinate properly with the other eye (turns of the eye that are too small to be seen by the parent) can result in vision loss that cannot be completely corrected in adulthood, but is relatively easy to treat in childhood.

• Evaluate the full range of visual skills that a child needs to perform effectively in school. If anomalies are revealed by the examination, they can often be handled with glasses alone or with glasses and vision therapy (sometimes called "eye exercises").

• Parents need to know enough to make good choices for their children. More information is always better than less. Make sure you really know how well your child sees.