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Pediatric eye exams



There’s More To Child Learning Than Just 20/20 Vision

Even if your child has “20/20” eyesight they may be experiencing vision problems. These problems may be causing learning problems and substandard educational results. A child’s visual acuity (how well s/he can see the wall chart) is an essential aspect of good vision but there are other factors which may prove more important. You may already be aware that a nearsighted child has little trouble reading or that good grades in school can be acquired even if much of the teacher’s board cannot be seen by the student.

Questions Related to Eyesight and Learning

Eye movement skills: Do your child’s eyes move across the page in a book smoothly and accurately?

Eye focusing abilities: Does your child change focus from near to far and back again – between reading text from a far-away white or black-board and writing on paper?

Eye teaming skills: Are your child’s eyes working together as a focus unit – do they come together for proper eye alignment for reading?

Binocular vision skills: Are your child’s eyes blending visual images from both eyes into a single, three-dimensional image?

Visual perceptual skills: Does your child identify and understand what s/he sees, co-relating importance, connecting with previous visual memorized information?

Visual-motor integration: Is the quality of your child’s eye-hand coordination balanced? Visual-motor integration is important not only for legible handwriting and the ability to efficiently copy written information from a book or board but also for sports. Deficiencies in any of these can be detrimental to a child’s learning ability and/or school performance.

Vision Problems Do Affect Kids Learning

Undetected learning-related vision problems in children are common. A child with an untreated vision problem may be misdiagnosed with behavior problems or ADHD/ADD when in reality they have a vision problem. Vision problems, in extreme cases, ignored or misdiagnosed, can become the true root cause of a child becoming the victim or aggressor in a school bullying tragedy.

Left untreated, vision problems will hinder your child’s learning in school. Studies have shown that at least 13% of children between the ages of nine-thirteen suffer from moderate to severe convergence insufficiency, the ability to bring one’s eyes together, which is crucial for good reading. Studies demonstrate clearly that 1 out of 4 school-age children suffer from at least one learning related vision problem.

Learning-Related Vision Problems

Signs and Symptoms

Some of the most common roadmap symptoms of learning-related vision disorders are:

  • Double vision, particularly during or after reading
  • Poor handwriting
  • Hyperactivity or recklessness during class
  • Word and letter reversals
  • Easily distracted during reading
  • Poor reading comprehension
  • Poor overall school performance
  • Circumventing of reading
  • Blurred vision, especially after reading or working closely
  • Eye Strain or frequent headaches

Call Spanish Oaks Eyecare to schedule a comprehensive child’s vision exam if your child exhibits one or more of these signs or symptoms and is exhibiting these types of problems in school.

Comprehensive Child Vision Exam

A comprehensive child’s vision exam includes tests performed in a routine eye exam, plus specific additional tests for detecting learning-related vision problems.

Extra tests would include accommodation, binocular vision, and ocular motility testing. In addition to these, depending on the type of problems your child is displaying, we may recommend other testing, either in our office or with a child’s vision and/or vision development specialist.

Vision Therapy

Special reading glasses or vision therapy may help your child if s/he has a learning-related vision problem that cannot be corrected with regular glasses or contact lenses. Vision therapy entails eye exercises and other activities specifically tailored for each patient to improve vision skills.

Learning Disabilities and Vision

Although children with learning disabilities may also have vision problems that are contributing to their difficulties in the classroom, vision therapy is a treatment for vision problems; it does not correct a learning disability. A child’s learning ability and school performance may indicate learning disabilities and/or vision problems.

Once your child’s comprehensive vision exam is completed, our doctor will advise you about whether a program of vision therapy could be helpful. We will refer you to a children’s vision or education/learning specialist if we do not provide the specified additional services your child needs.

Eye Exams in School-Aged Children: Ages 6-18

Undetected or uncorrected vision problems can cause children and teens to suffer academically, socially, athletically and personally. If your child is having trouble in school or afterschool activities there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but also the ability of your eyes to work together. Children that have problems with focusing, reading, teaming their eyes or hand-eye coordination will often experience frustration, and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal, so they aren’t able to express that they need help.

In addition to the symptoms written above, signs of vision problems in older children include:

  • Short attention span
  • Headaches
  • Frequent blinking
  • Avoiding reading
  • Tilting the head to one side
  • Losing their place often while reading
  • Double vision
  • Poor reading comprehension

The Eye Exam

In addition to basic visual acuity (distance and near vision) an eye exam may assess the following visual skills that are required for learning and mobility:

  • Binocular vision: how the eyes work together as a team
  • Focusing
  • Peripheral Vision
  • Color Vision
  • Hand-eye Coordination
  • Tracking

The doctor will also examine the area around the eye and inside the eye to check for any eye diseases or health conditions. You should tell the doctor any relevant personal history of your child such as a premature birth, developmental delays, family history of eye problems, eye injuries or medications the child is taking. This would also be the time to address any concerns or issues your child has that might indicate a vision problem.

If the eye doctor does determine that your child has a vision problem, they may discuss a number of therapeutic options such as eyeglasses or contact lenses, an eye patch, vision therapy or Ortho-k, depending on the condition and the doctor’s specialty. Since some conditions are much easier to treat when they are caught early while the eyes are still developing, it is important to diagnose any eye and vision issues as early as possible.

Following the guidelines for children’s eye exams and staying alert to any signs of vision problems can help your child to reach his or her potential.

Why is it important to get an Eye Exam done when your child has already had a Vision Screening?

Vision screenings are there to indicate a vision problem, they are referred for further evaluation.

However, a vision screening can’t be relied on to provide the same results as a comprehensive eye examination.

Screenings can take many forms. Often schools provide periodic vision screenings for their students. A pediatrician or other primary care physician may do a vision screening as part of a school physical. When applying for a driver’s license, your vision will likely be screened. Vision screenings are often part of local health fairs put on by hospitals, social service agencies or fraternal groups like the Lions and Elks clubs.

Vision screenings can uncover some vision problems, but they can miss more than they find. This is a major concern about vision screening programs.

Current vision screening methods cannot be relied on to effectively identify individuals who need vision care. In some cases, vision screening may actually inhibit the early diagnosis of vision problems. Screenings can create a false sense of security for those individuals who “pass” the screening but who actually have a vision problem. These people are then less likely to receive treatment for their vision problem and it could become worse.

Undetected and untreated vision problems can interfere with a child’s ability to learn in school and participate in sports. They can also affect an adult’s ability to do their job or to drive safely. The earlier a vision problem is diagnosed and treated, the less it will impact an individual’s quality of life.

What are the limitations of vision screening programs?

To understand why vision screenings may not find a vision problem, let’s look at the factors that can limit their effectiveness.

  • Limited testing. Many vision screenings test only for distance visual acuity. While the ability to see clearly in the distance is important, it does not indicate how well the eyes focus up close or work together. It also does not give any information about the health of the eyes.Some screenings may also include a plus lens test for farsightedness and a test of eye coordination. However, even these additional screening tests will miss many vision problems.
  • Untrained personnel. Often, administrative personnel or volunteers who have little training conduct a vision screening. While well-intentioned, these individuals do not have the knowledge to competently assess screening results.
  • Inadequate testing equipment. Even when done in a pediatrician’s or primary care physician’s office, the scope of vision screening may be limited by the type of testing equipment available. Factors such as room lighting, testing distances and maintenance of the testing equipment can also affect test results.

People often misunderstand what passing a vision screening means. The information obtained from a vision screening is comparable to the information obtained from a blood pressure measurement. Your blood pressure may be in normal range, but that doesn’t mean that you do not have other health problems. It’s merely a single measure of one aspect of your overall health. Just like you need a complete physical to evaluate your total health, only a comprehensive eye and vision examination can evaluate your overall eye health and vision status.

Now that you can see the importance of getting your child’s eyes checked by an eyecare professional, and have learned how it’s done, give us a call (or send us a text!) to schedule your family’s eye appointments. We look forward to seeing you!