Child Vision Problems in the Classroom How to Screen for & Spot Early Warning Signs at School

Meet the Experts

Katherine K. Weise Pediatric Vision Specialist Read bio
Gayle Y. Daniels Optometrist, Pediatric Vision Advocate Read bio

Written by…

Chandra Whitfield Read bio

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.

How to Spot Warning Signs of Vision Problems in the Classroom

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

  • Swollen eyelids

  • Sties or infections on eyelids

  • Excessive clumsiness, diminished coordination

  • Poor penmanship

  • Complaining that computer use “hurts his eyes”

  • Lower than usual academic performance

  • Often loses place while reading

  • Difficulty remembering what is read

Is it ADHD, a Vision Problem or Both?

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.”

Learning-Related Vision Problems & How They’re Treated

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
  • Crossed eyes
  • Frequent squinting
  • Tilting the head to see better
  • Some children may have poor depth perception and problems seeing in three dimensions
How it’s treated

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.

How Teachers Can Help Students with Vision Problems Succeed

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

Resources

There are plenty of organizations dedicated to sharing and providing many of the resources available to help parents support their children with vision problems.

  • Children’s Eye Foundation

    Nonprofit that for more than 40 years has provided educational programs and advocacy efforts dedicated to its mission: to eliminate preventable blindness in children.

  • Delta Gamma Center for Children with Visual Impairment

    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.

  • Lighthouse Guild

    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.

  • Family Connect

    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.

  • Eye Care 4 Kids

    Provides professional eyecare service referrals for low income, visually impaired children and families from underserved communities.

  • Institute for Families

    A non-profit organization that provides no-cost help for families of children with vision loss, including counseling and support services.

  • The Vision of Children Foundation

    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.

  • Vision to Learn

    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.

  • Teaching Students with Visual Impairments

    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.

  • The Vision Therapy Center

    Website that provides instructional tips and resources to help teachers strengthen their awareness of learning-related vision problems.

  • Perkins School for the Blind

    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.

  • National Catalogue for Copyright Works in Alternate Formats

    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.

  • Bright Hub Education

    Helpful advice, resources and lesson plan ideas aimed at helping teacher accommodate the needs of students with partial or full visual impairment.

  • National Association of School Nurses

    Online guide provides information and resources for school nurses, including the in-depth “12 Components of a Strong Vision Health System of Care” guide.