Thursday, March 21, 2013

Vision and Learning

When we talk about vision, most of us think of eyesight, also called visual acuity.  If it appears a child is having a difficult time seeing, he is taken to an optometrist for an eye exam where the child will be asked to read a chart on the wall to determine whether he has "20/20 vision".  The term "20/20" means the wall chart can be seen as clearly as expected at a distance of 20 feet.  The doctor will also check to make sure the eyes are healthy and free of disease.  A child who does not have 20/20 vision is prescribed glasses.  But if a child does have 20/20 vision, we are often told that her vision is fine.  But is it really?

What many parents, educators, and other professionals who work with struggling learners do not know, is that vision actually involves many aspects beyond visual acuity.  A student may have 20/20 vision but still have a significant vision problem which will interfere with academic learning.  The visual skills needed for sustained reading of small print at 11 to 16 inches from the face are greater and more complex than those required to read letters on a chart 20 feet away. 

Vision is the ability to receive visual information, process the information and obtain meaning from it.  Vision is not automatically acquired; it is learned as children explore and interact with their environment.  The visual skills a child needs in order to learn to read begin in infancy.  He learns to follow a toy with his eyes, to judge depth in order to reach for and grasp objects in space, and to converge his eyes on an object in his hands. He learns to follow and focus on his own hands as he crawls and to move his eyes independently of his head.  He figures out where he is in space in relation to the world around him.  Later he learns to catch a ball, hop, skip a rope, balance on a bicycle, all of which further develop his ability to process visual information.   These are just a few examples of the many skills which develop vision.  With the often excessive use of TV and electronics in our modern society, it is pertinent that parents and educators realize the importance whole body interaction with the environment to fully develop visual skills. 
At the beginning of this article, I referred to a typical eye exam for acuity, but there is a specialized area of optometry called developmental optometry.  Developmental optometrists have equipment and techniques to evaluate additional areas of vision beyond acuity. When developmental optometrists find weaknesses in visual skills they may prescribe glasses which help train the eyes and/or they may recommend therapy to address the missing skills.
Visual skills which developmental optometrists evaluate include:
  • Binocular coordination: the ability of the eyes to work together as a team.  Some children have difficulty coordinating their eyes, especially over an extended period of time.  The eyes may tend to drift apart, they may tend to drift together, or one eye may drift in or out.  Each eye is controlled by the opposite hemisphere of the brain.  The two sides of the brain must be well integrated in order to keep the eyes working as a team.  When a child has to expend excess effort to maintain eye coordination, comprehension is lost, and he becomes fatigued and "attention deficit".  When eyes do not coordinate together there may be periods of double vision, blurred vision, or words seeming to move on the page, especially when the eyes are tired.
  • Oculomotor skills: the fine movements of the eyes.  One type of oculomotor skill is the abiltiy of the eyes to make small jumps from word to word as they move across the page.  Inefficient eye movements cause children to confuse words, skip words, and skip lines. 
  • Accomodative functionthe ability to quickly refocus when moving eyes from point A to point B, for instance when copying from the white board to a piece of paper.  
  • Visual Perception: being able to acurately interprete and remember what is seen, such as recognizing the orientation of the letters "b" and "d," remembering sight words, and being able to visualize what is happening in a story.    
Some signs that indicate possible vision problems include:
  • headaches when reading
  • watery or itchy eyes
  • words becoming blurry
  • words looking "double"
  • words seeming to move around on the page
  • covering one eye
  • tilting the head
  • odd posture
  • bringing the eyes too close to the page
  • tracking with a finger
  • skipping words and/or lines
  • reading becoming slower and fidgeting increasing the longer a student reads
  • poor letter formation, writing may slope, not be "on the line,"  and spacing may be random
  • letters like "b" and "d" may be frequently reversed
Understandably, students with vision problems usually do not read for pleasure and tend to avoid tasks which require reading because it is tiring.  A child who has never experienced normal vision, is unlikely to realize there is something different about the way he sees.
When, for whatever reason, a child does not naturally develop the visual skills needed for academic learning, deficit visual skills can be taught through a program of therapeutic exercises.  Improving visual skills can take much of the struggle out of learning and greatly increase the success of academic remediation. 

In my practice as a private educator, I have found functional vision deficits to be a common problem among children who are having trouble with academic learning.  All children who are evaluated at ILC are screened for developmental vision problems.  Referrals to a developmental optometrist are given when needed.


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