In a recent interview with the president of the American Optometric Association (AOA), Dr. Dori Carlson, I learned the surprising statistic that about 1 in 4 school age children have an undetected or undiagnosed vision problem. School vision screenings, while helpful, still miss more than 75% of these problems. And for those kids who are discovered to have a vision problem during a school screening, upwards of 40% receive no follow up after the diagnosis. Clearly, we need to do better at diagnosing and treating childhood visual deficits..
Dr. Carlson told me that the solution involves comprehensive eye exams – a full medical eye exam performed by an eye doctor. During a comprehensive eye exam, the optometrist will check the health of the eye tissues, including the eye muscles, cornea, conjunctiva, tear ducts, pupils, lens, and retina, as well as the patient’s ability to track objects, to see at different distances, and to focus adequately.
Vision correction is important at the youngest age possible because learning is greatly impacted by vision. Children who can’t see the chalk board, or who can’t read a computer screen or book, may lag behind in school or have attention challenges. In fact, it’s likely that some visually impaired children are misdiagnosed with ADHD (Attention Deficit Hyperactivity Disorder) as their interest in lessons fade since they can’t participate well without seeing what’s going on.
Dr. Carlson told me that parents sometimes erroneously believe that they’d be able to tell if their child has a visual deficit. In her experience, some children have been misdiagnosed with balance and hearing problems when they actually had a strong visual deficit in one eye. In one case, a 7 year old boy learned to ride his bicycle so that he turned right three times in order to go in a leftward direction because his left eye had poor vision.
So why are vision problems so common among children? According to Dr. Carlson, babies are all born far-sighted, and they begin to gain near vision when they’re 6 months old. However, many babies and young children lose their farsightedness at different rates in each eye. If the rates vary by quite a bit, vision can be greatly impacted, and early interventions with corrective lenses and/or eye patches can be critical in heading off long term problems. The best way to assess a baby or young child for such problems is to have a comprehensive eye exam by an eye care professional. It is recommended that children have exams beginning at age 6 months to 1 year and then every 2 years or so thereafter.
Dr. Carlson and the AOA are so committed to making 
comprehensive eye exams available to all Americans that they have founded the InfantSEE program. The InfantSEE website (www.infantSEE.org) provides a nation-wide list of optometrists who offer free exams to infants, regardless of the parents’ health insurance or ability to pay.
So there you have it, parents – please make sure that your child is set for success this school year by taking him or her to an eye care professional for a comprehensive exam. School vision checks are not designed to assess the whole eye and all the possible vision problems that occur. Remember that you can’t tell if your child has a vision problem just by looking at them!
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–click here to listen to the full conversation with Dr. Carlson–