Do Vision Screenings Fail Our Children?
Although vision screenings pick up children who have vision problems, not all children with vision problems are picked up on vision screenings. Screenings easily detect children who are myopic (near-sighted). But children with significant vision and eye problems can pass a vision screening test for the following reasons:
1. Screenings may fail to detect children who cannot sustain clear and comfortable reading vision. A child can pass a distance vision acuity test, yet still have vision problems that affect learning. Many of these children are so accustomed to eyestrain and reading difficulty that they do not realize they are having a problem.
2. Vision screenings pass children with 20/40 visual acuity or better. That may have been acceptable 50 years ago. It’s not acceptable in the visually complex world we now live in. For optimum clarity and comfort, I would want my children seeing 20/20 and not a minimal standard of 20/40.
3. Screenings miss children with anisometropia (an example of this is a child that has one eye that is far-sighted and the other eye is astigmatic). I’ve seen children with as many as 10 steps difference between the right and left eye who have passed vision screenings! A difference such as this can affect visual clarity, comfort, sports vision co-ordination and driving safety. These children often end up suppressing the vision of one eye. That’s a heavy price to pay for relying on a vision screening instead of an eye exam.
4. Screenings can miss children with hyperopia (far sighted). Because of the extra focusing effort these kids have to make in order to see clearly, they may have trouble concentrating on schoolwork or they may decide they don’t “like” to read.
5. Screenings can miss children with amblyopia (lazy-eye) where the amblyopic eye is 20/40 or better.
6. Screenings can miss children with intermittent strabismus (eye turn). These kids are visually uncomfortable because of the instability of their visual system.
7. Screenings can miss children with medical eye problems. Unfortunately not every healthy child has healthy eyes.
8. Some kids with significant astigmatism can still pass a vision screening.
A few days ago we were examining a mom and dad who happened to bring their grade school child with them. Since we had an opening in our exam schedule, the parents of this child decided to have her eyes examined also. What we found was that this young child — who had passed pediatrician and school screenings –had six “steps” (1.50 diopters) of astigmatism in each eye. She even had mild amblyopia (lazy eye). Fortunately, we will probably be able to eliminate the amblyopia with the use of the proper glasses prescription.
Our office can help parents check their vision plan benefits. Most vision plans cover adults and children.
80% of learning occurs using vision. It makes good sense to make sure your child has the best possible vision and healthy eyes. Eye exams can do that; vision screenings can’t.
Dr. Ally Stoeger provides annual eye examinations (including children’s eye exams), medical eye care, contact lens examinations and Lasik surgery co-management in the Gainesville-Haymarket area of Virginia. Her practice at GH Eye has a superb collection of basic and hi-tech lenses and the latest in fashion frames for adults and children.