Solutions for your child who struggles in school starts by knowing what to ask your eye doctor


We’ve all had the experience of a “rushed” medical examination. The doctor is trying to see many waiting patients and quickly making decisions about why we are there.

But, when it comes to your child who has had a rough year at school in reading and learning, the evidence is clear, it is essential that your child be given a comprehensive eye health and vision evaluation that targets the categories of vision development that can be associated with reading/learning problems. Ruling out eye disease is important with all patients. This can take up to 15 minutes of a standard eye examination especially when it involves dilation of the pupils.

However, for those children with vision related reading and learning problems, the research shows in multiple studies and outlined by the American Optometric Association(AOA), a comprehensive vision evaluation that involves refraction (testing for corrective lenses) and additional testing of binocular vision (eye teaming) accommodation (eye focusing), oculomotor skills (eye movement control) and visual processing abilities is an essential prerequisite to identify underlying vision problems that could be the cause for a child who struggles in school. This often requires more time and decision making than a 15 minute eye health examination alone.

For example, here is a sample of the American Optometric Association’s (AOA) outline of the Pediatric Chairside Guide for children 6-12 years old:

Also, here is an outline developed by the College of Optometrists in Vision Development (COVD) of symptoms and potential areas of vision problems associated with these symptoms.

For concerned parents and family members, when you understand the cause of a problem you are better equipped to do something about the problem. In vision-based reading and learning problems, when the cause is due to problems in eye teaming, focusing, tracking or visual processing, the treatment, developmental vision and rehabilitation/vision therapy, can often make a dramatic difference in a child’s reading and learning performance. But, first it is essential that any child who struggles in school, reading and learning, has an IEP or has ADHD behaviors has a comprehensive eye and vision evaluation with the necessary assessment of core elements of developmental vision.

How can you be a proactive parent when your child has reading and learning problems? Begin by asking questions to find out if your primary care Doctor of Optometry will look deeper into your child’s history and will perform the comprehensive testing as outlined by the American Optometric Association (AOA) or will refer your child to a Developmental and Rehabilitation Optometrist who performs the necessary diagnostic evaluations and provides office-based vision therapy treatment when necessary.

By asking if the doctor will be able to evaluate  “eye teaming”, “eye focusing”, “eye tracking” and “visual processing” as outlined by the AOA, shows that you are a proactive parent, understanding what your child needs in testing and, when necessary, treatment. That’s how you can find the help that could change the trajectory of your child’s academic career.

For additional information including videos, books, definitions, white papers, research, presentations, and links to optometric organizations go to the VisionHelp Vision and Learning Project.

Dan L. Fortenbacher, O.D., FCOVD

6 thoughts on “Solutions for your child who struggles in school starts by knowing what to ask your eye doctor

  1. Dan, This is another understandable explanation which will help parents help their children with visual problems which are interfering with their potential to learn and perform. Gary

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