4D Vision Gym

Pediatric Eye Exam

Why a Pediatric Eye Exam or
School Vision Screening Is Not Enough!

Pediatric eye exams and school vision screenings typically only test distance vision.

According to Dr. Collier during the interview on the Better Connecticut TV show, “behavioral optometry examines what we do with our vision, not just our 20/20 eyesight, which is what we usually think about when we think about going to the eye doctor’s office. So, when you think about reaction time, reading, sustaining clear vision at reading, taking notes from the board, and catching balls when you’re playing sports, all of those things are a function of your visual system which has nothing to do with your 20/20 distance vision. However, most children aren’t checked for near vision.”

The article below is a reprint of “About Pediatric (Children’s) Eye Exams or Vision Screenings” from the Optometrists Network, and it explains why a pediatric eye exam or a school vision screening are inadequate for ensuring that children achieve their full academic potential.


“Many parents today are under the impression that the vision screening their children receive from the school nurse is sufficient,” says Jeffrey R Anshel, DS, OD. “The screening [at school] will determine the child’s distance vision but what is missing is the near vision. Very few eye screenings include this much-needed exam. Just as children should visit the pediatrician and the dentist, they should also see a licensed eye care provider to screen for vision problems.”

A functional vision evaluation includes testing and evaluation of visual skills (function, performance, etc.) In the absence of complete testing, common pediatric vision problems can go undetected, and, in some cases, can be misdiagnosed as a learning disability or behavioral problem. This page lists some of the visual skills which need to be evaluated as part of a child’s comprehensive vision examination.

Vision Screenings Only Test Distance Vision

Many school eye or vision screenings test only one of the
visual skills listed below — that is, Acuity-Distance (clarity
of sight in the distance, 20/20 eyesight as measured by
the standard Snellen eye chart).

A child’s functional vision evaluation should include testing
of the following visual skills, ALL of which are important
aspects of normal, healthy human vision.

Acuity – Distance Vision: visual acuity (sharpness, clearness) at 20 feet distance.

Acuity – Near Vision: visual acuity for short distance (specifically, reading distance).

Focusing Skills: the ability of the eyes to maintain clear vision at varying distances.

Eye Tracking and Fixation Skills: the ability of the eyes to look at and accurately follow an object; this includes the ability to move the eyes across a sheet of paper while reading, etc.

Binocular Vision or Fusion: the ability to use both eyes together at the same time.

Stereopis: binocular (two-eyed) depth perception.

Convergence and Eye Teaming Skills: the ability of the eyes to aim, move and work as a coordinated team.

Color Vision: the ability to differentiate colors.

Reversal Frequency: confusing letters or words (b, d; p, q: saw, was; etc.)

Visual Memory: the ability to store and retrieve visual information.

Visual Form Discrimination: the ability to determine if two shapes, colors, sizes, positions, or distances are the same or different.

Visual Motor Integration: the ability to combine visual input with other sensory input (hand and body movements, balance, hearing, etc.); the ability to transform images from a vertical to a horizontal plane (such as from the blackboard to the desk surface).

A Pediatric Eye Exam That Only Tests Distance Is Not Enough

Remember: an eye exam that tests distance vision only is NOT an adequate evaluation of a child’s visual development. The visual skills listed above contribute significantly to a child’s success with reading and school achievement. Learn more about success in school: Vision is More Than 20/20!

Here are some common pediatric visual conditions which are not detected through the 20/20 eye chart test alone: Amblyopia (Lazy Eye), Strabismus (Deviating Eyes), Convergence Disorders.

Please note: In-office therapy under the direction of a behavioral optometrist using prisms, filters and lenses, as used with our patients, is far more effective than home-based therapy.

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