There are just over 500,000 children with vision difficulty in the U.S., according to the 2016 American Community Survey (ACS). Vision issues are about more than just having problems seeing; they can contribute to learning problems, poor academic and athletic performance, developmental delays and behavioral issues. The good news is that early diagnosis and treatment of vision disorders can help support more normal visual development, prevent further loss of vision and help equip children with the tools needed to succeed.
This guide provides insight and expert recommendations for common vision problems, discusses how those issues can be detected and treated and offers tips and resources to help teachers identify potential vision problems among school-aged children.
While you should never attempt to diagnose or treat an eye problem on your own, don’t underestimate your ability as a parent or educator to notice that something may not be right with a child’s vision. Here are signs you can look for in the classroom and beyond that may mean a vision problem exists:
Constant squinting or grimacing when reading or focusing
Holding books close to face when reading
Sitting close to the television or blackboard
Complaints of blurred, cloudy or double vision
Complaints of headaches, nausea or dizziness
Constant burning, itchy or watery eyes
Unusual sensitivity to light
Closing or covering one eye while reading or focusing on close objects
Crossed or “lazy” eye
Low attention span, fidgetiness and behavioral problems
Tilts head forward or backward when looking at distant objects
Discolored or unequal pupil size
Problems with reading, low reading comprehension and poor spelling
Sties or infections on eyelids
Excessive clumsiness, diminished coordination
Complaining that computer use “hurts his eyes”
Lower than usual academic performance
Often loses place while reading
Difficulty remembering what is read
Excessive fidgeting, hyperactivity and high distractibility are some of the symptoms associated with Attention Deficit Hyperactivity Disorder (ADHD). However, those same symptoms may also indicate that a child is struggling with an undiagnosed vision problem. Sometimes the only tipoff for parents or educators is the disciplinary problems that the child begins experiencing at school.
“Due to these similarities, some children may be mislabeled,” explains optometrist Gayle Y. Daniels, founder of the Daniel Migael Foundation, Inc. For this reason, experts agree that children should be given a comprehensive eye exam to rule out vision problems before making an ADHD diagnosis.
“Eye doctors do not identify or treat ADHD, but they can rule out eye conditions that may mimic ADHD or contribute to reading difficulty,” explains Katherine K. Weise, director of Pediatric Optometry Service at the University of Alabama at Birmingham (UAB) Eye Care and the UAB School of Optometry.
A study from the American Academy of Optometry also concluded that children with vision problems, such as crossed eyes or disorders related to eye movement, were two times more likely to develop ADHD. In the study, 5.6 percent of those with vision problems were found to have ADHD, while only 8.3 percent of children with normal vision had exhibited symptoms of the condition. The presence of ADHD was even higher among children with moderate vision issues.
“Because of the associations with vision conditions, all children with developmental delay or special needs should skip the vision screening and seek out a dilated eye exam by a pediatric eye doctor,” suggests Weise.
Daniels adds that parents must be vigilante and pay close attention to all of the symptoms that their children are experiencing. “Both conditions require diagnosis and treatment from a medical professional,” she says. “Parents should remember to include routine eye examinations as part of the overall wellness care of their child.”
Many vision problems aren’t obvious to those without professional expertise, while others are more easily detectable through general observation. Here are some conditions that may affect school age children; academic performance and behavior often suffer as a result. Experts suggest that you contact your child’s doctor if you notice any of the symptoms described.
“Lazy eye is also known as amblyopia and is a result of poor vision development,” says Weise. “At least two percent of the population has a lazy eye. The majority of lazy eye is in one eye and due to uncorrected refractive error (a need for glasses to correct for near-sightedness, far-sightedness, or astigmatism).”Symptoms
Glasses, eye patches, eye drops, surgery, or a combination of them are used to force the brain to pay attention to the images of the amblyopic or weaker eye so vision in that eye gets stronger. Amblyopia should be treated as early as possible, as research has shown it is more difficult to treat with each passing year, especially after the age of 9.
Also a “refractive error;” it occurs when an eye has an abnormal curvature — instead of being round like a basketball, the eye may be shaped more like a football. Approximately 15 to 28 percent of children ages 5 to 17 have astigmatism, according to the nonprofit advocacy group Prevent Blindness.Symptoms
Astigmatism usually can be corrected with glasses or specially-shaped contact lenses, that add more curvature and focusing power in one axis of the eye than the other. This helps keep images from being distorted.
Also called farsightedness, this common type of refractive error in the eye occurs when the eyeball is too short or the cornea has too little curvature leaving the eye unable to correctly focus on the light that enters it. “About 21 percent of younger children and 13 percent of older children are farsighted,” says Weise. “These kids have difficulty seeing up close or reading for long periods of time.”Symptoms
Often with glasses or contacts. “A small amount of far-sightedness can be self-corrected by using the eye’s focusing muscles,” says Weise. “For higher amounts of farsightedness, glasses are helpful in avoiding eyestrain, intermittent blur or headaches at the end of the day.”
Often called a “cat eye,” it’s a pupil that looks white. The most common cause among children is cataract, a clouding or opaque area over the lens of the eye.Symptoms
Surgical treatment should be completed immediately to avoid permanent visual loss and the potential for retinoblastoma, a life-threatening condition that is the most common eye cancer in children.
Also known as nearsightedness, myopia is among the most common “refractive errors,” because it impacts how the eyes “refract,” or bend, light that is projected onto the retina of the eye. It occurs when the eyeball is too long or the cornea, the front cover of the eye, is too curved that it affects the light entering the eye.
“About four percent of young children and nine percent of older children are nearsighted,” says Weise. “The prevalence of nearsightedness has nearly doubled in the last two decades. Researchers are studying why that is. We are looking for treatments that show promise in slowing the growth of nearsightedness using special contact lenses and/or eye drops and modifying environmental factors like getting outdoors more often.”Symptoms
With glasses or contacts.
What it is: A drooping eyelid that diminishes visibility in the eye. The drooping eyelid blocks part of what the eye can see which may affect a child’s ability to read. It may also be a sign of a more serious medical condition. In a young child, it can lead to astigmatism and eventually amblyopia.Symptoms
Surgery tightening the elevator muscles to lift the eyelids for improved vision and appearance is usually the best treatment.
Also called “cross-eyed,” “squint” or “wall-eyed,” this vision condition results when both eyes are unable to align simultaneously. “About two percent of the population has strabismus, or an eye turn,” says Weise. “A child may see double in cases of strabismus. He may also choose to turn off or suppress the vision in one eye. While this helps the child avoid double vision, it increases the risk for lazy eye because one eye is getting more visual connections to the brain than the other is.”Symptoms
With early detection, vision can be restored by covering the properly aligned eye with a patch, forcing the misaligned eye to work. In some cases, surgery or specially designed glasses are needed to help realign the eyes.
Here are some ways that teachers can help students with vision problems succeed in the classroom.
Consult with an O&M (orientation and mobility) specialist regarding needed/requested modifications
Use high contrast writing instruments on boards; for example, white chalk on a clean chalkboard or dark markers on dry erase boards
Avoid writing in bright colors like red, orange and yellow on paper and Smartboards
Use soft lead pencils and felt-tipped pens with black ink on light or tinted paper
Allow the student to move seats or adjust the position of his/her work as needed
Verbalize as you write on the board or make demonstrations
Avoid large print materials; some vision conditions may distort those images
Seat student near the board (within 3 to 5 feet) when needed
Avoid any terminology that requires visual acuity; such as “over there” and “like this one”
Try partnering the visually-impaired student with another student for help and support
Give the visually impaired student extra time to complete work when needed or requested
Provide a personal tour of the school, classroom, restrooms and other areas of the school
Modify physical education class activities, such as catching, kicking and throwing as needed
Darken or adjust classroom lighting as needed
There are plenty of organizations dedicated to sharing and providing many of the resources available to help parents support their children with vision problems.
Nonprofit that for more than 40 years has provided educational programs and advocacy efforts dedicated to its mission: to eliminate preventable blindness in children.
A nonprofit aimed at improving access to family-centered and specialized services and support referrals for families with children who are blind or visually impaired.
Leading not-for-profit healthcare organization dedicated to providing resources for parents of newly-diagnosed children with visual impairments. They provide resources for e-learning and coordinated care.
A website created by the American Foundation for the Blind (AFB) and the National Association for Parents of Children with Visual Impairments (NAPVI) that gives parents of visually impaired children a place to support each other, share stories and concerns and find resources on raising their children from birth to adulthood.
Provides professional eyecare service referrals for low income, visually impaired children and families from underserved communities.
A non-profit organization that provides no-cost help for families of children with vision loss, including counseling and support services.
Non-profit that provides research funding, education and support for a worldwide network of families affected by vision disorders, including video magnifiers that assist American students with low-vision.
Advocacy organization that provides children with free eye exams and free glasses by bringing its mobile eye clinics to schools and community organizations.
Many organizations provide helpful tips, tools and resources aimed at helping teachers and others in the educational setting address the unique needs of students with vision problems and impairments that are critical to the success of students facing vision problems.
Website provides a list of visual impairment program resources for educators, vision professionals, family members and others seeking support and referrals for those with a visual impairment.
Website that provides instructional tips and resources to help teachers strengthen their awareness of learning-related vision problems.
Massachusetts-based school for the blind provides resources for teachers, families and professionals around the globe, including information on workshops, services, education and community resources that support those with visual impairments.
An online catalog of copyright works in alternate formats for people with print disabilities. Users may easily upload and search for copyright works in alternate formats such as Braille, large print, digital and audio.
Helpful advice, resources and lesson plan ideas aimed at helping teacher accommodate the needs of students with partial or full visual impairment.
Online guide provides information and resources for school nurses, including the in-depth “12 Components of a Strong Vision Health System of Care” guide.