It is the first grade and students are lining up in the cafeteria for the school vision screening. As each child’s turn arrives, they are asked to read from a simple eye chart about twenty feet away. This tests for nearsightedness, the most easily detected eye problem. Nearsighted or myopic children see more easily at near, but experience blur at distance and often have difficulty seeing the chalkboard. Interestingly, nearsighted students are often high achievers at school because they are “pre-focused” for reading.
Farsightedness or hyperopia is more difficult to detect. However, additional testing such as retinoscopy and cover testing can reveal farsightedness and the tendency for the eyes to cross. Children with farsightedness often seem to have perfect distance and near vision. These children are forced to focus the lens inside their eye to see clearly when they are looking in the distance and at near. Youngsters with “normal” vision only focus for near tasks like reading or coloring. For this reason, farsighted children need to work harder at keeping their textbooks in focus and are more likely to avoid reading.
The additional effort of focusing caused by uncorrected farsightedness can also give the eyes a tendency to cross making it more difficult to read. Children with this problem may experience a delay in learning to read that can be confused with Attention Deficit Disorder. These students tend to be more frustrated by the reading process as their classmates advance in this important skill.
Some children who are born with higher levels of farsightedness are unable to overcome the tendency for the eye to turn in. They begin to ignore the image from the turned eye in order to avoid seeing double. Because the brain is no longer receiving a clear image, the normal neurological connection between the brain and the retina is not established. These children have a condition called amblyopia where normal sharpness of vision has failed to develop. Undetected amblyopia leaves the child with permanently decreased vision in one eye and diminished depth perception.
Early vision testing can help to ensure the proper development of vision. I recommend youngsters have their eyes examined at six months, two years and just before school starts. School age children should be seen every year or two depending on their visual status.
