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Learning Related Vision Problems get National Attention

By Dr. William Moskowitz

According to the National PTA, "It is estimated that more than ten million children (ages 0-10) suffer from vision problems..." and "Typical 'vision' evaluations/screenings only test for a few of the necessary learning related visual skills (...i.e., 20/20 eyesight) leaving most visual skill deficiencies undiagnosed..."

The PTA further states, "Knowledge regarding the relationship between poorly developed visual skills and academic performance is not widely held among students, parents, teachers, administrators, and public health officials..." In fact, the National PTA resolved to "provide information to educate members, educators.... and the public at large about learning related visual problems..."

Many times an undiagnosed vision problem can look like a learning disability, since the vision problem definitely interferes with the learning process. It is not uncommon for students who have undiagnosed vision problems to appear to be (and are thus labeled) ADD (Attention Deficit Disorder), ADHD (Attention Deficit Hyperactive Disorder), and LD (Learning Disabled). Research has shown, however, that when the vision problem is treated, these students will then respond to academic assistance. Some of these visual problems might be correctable with glasses. However, there could be more complex issues. If visual acuity (clear sight) and the health of the eye are fine, yet reading and/or school work is a struggle, there may be an undetected learning related vision problem.

Most people think that if their child sees "20/20", everything is fine. But, according to Dr. Moskowitz, 20/20 is just one of the many visual skills required for learning. What is 20/20, anyway? It is the ability to see at 20 feet what a person should be able to see on an eye chart at 20 feet. And that is what the school nurse tests for in school vision screening programs. Such programs are fine for the majority of the population. Unfortunately, one out of every four children struggles with undetected learning related vision problems which are not detectable in this type of screening. And, many of those children passed the screening test with results of 20/20.

Basic vision skills required for school include: near vision (the ability to see clearly and accurately that which is on a desk or close at hand), distance vision (the ability to see clearly and comfortably at a distance of ten or more feet - such as from a student's desk to the chalkboard), binocular coordination (the ability to have both eyes work together to see a clear, single image), eye movement skills (the ability to have both eyes aimed accurately, track across a line of print, and move fluidly from object to object with ease). eye-hand coordination (the ability of the eyes to guide or direct the hands) and focusing (maintaining completely clear vision while reading). A child will have to work harder than usual if one or more of these skills is inadequate or missing. It is easy to see, then, why simply reading an eye chart will not give an adequate assessment of visual functioning.

Some of the symptoms for which parents and teachers should be on the alert, and which might indicate that a child has a vision problem are: poor concentration, comprehension and attention span, fatigue, squinting, complaints of double vision or blurring loses place while reading, points to words while reading, avoids close work, rubs eyes or blinks a great deal while reading, has nausea, headaches after close work, reverses letters or words in reading and /or writing, omits small words or makes substitutions while reading, AND homework takes FOREVER when it shouldn't. This is by no means a complete list of symptoms, but are some of the most obvious.

If a child is bright and has no physical problems, but hates to read and does poorly in reading, writing, math and spelling, he/she may have an undetected learning related vision problem. Unfortunately, this child is often seen by parents and teachers as lazy and, in many cases, learning disabled, thus contributing to low self-esteem, and feelings of stupidity. To make matters worse, many children (and adults, in fact), don't report their symptoms - they are unaware that they do not see they same way as everyone else. So, if your child exhibits any of the symptoms listed above, it might be a good idea to ask him/her to describe how he/she sees. You might be surprised to hear, for example, that a line of print splits into two images after just a few minutes of reading. Imagine how exhausting it would be to read under those conditions!

What can you do to ensure that your child has all the visual skills required for spelling, reading and learning, in general? Have your child evaluated by a developmental optometrist - one who, in addition to testing acuity (clarity of sight), will assess all the visual skills required for learning: specifically, eye movement control, eye focusing at distance and near, depth perception, visual motor integration, visual memory, form perception, and eye teaming ability.


Dr. William Moskowitz is a board certified developmental optometrist who has been in practice for over forty years. He trained at the Gesell Institute at Yale University and is an expert in pediatric developmental optometry. He has lectured internationally and was a contributor to a textbook on pre-school vision. Dr. Moskowitz, whose practice specializes in the diagnosis and treatment of vision-based learning problems, is a popular speaker with parent and professional groups. Individuals and groups can contact his office, the Park Vision Therapy Center, at (908) 725 1772, and ask to speak to Nan Miller, the Vision Education Coordinator,