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Why A Vision Screening in Lancaster County Is Not Enough

How can I tell if my child has vision problems that affects their ability to read and learn?

Learning is 80% visual. Reading, writing, computer work, and seeing the board are all learning tasks that our children are required to perform in order to succeed in school. These visual tasks require accurate vision and quick visual response times at near and far distances.

Good Vision Much More Than 20/20

Eye care professionals believe that 20% of school-aged children do not possess the visual skill set needed to excel in school. This is independent of whether or not a child needs corrective lenses or glasses. Having 20/20 vision is only one aspect of measuring one's vision.

Vision isn’t just about seeing well, but it’s about how we interpret and interact with the information in front of us. One can pass all vision screening exams and excel in reading the charts, but still struggle with dyslexia, have poor hand-eye coordination, diminished focus, strabismus, convergence insufficiency and amblyopia.

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What Symptoms Should You Look Out For?

Teachers, parents, and adults should be on the lookout for the symptoms listed below, as they may indicate a vision issue.

  • Lazy eye, cross eye, double vision
  • Difficulty Reading
  • Poor classroom performance
  • Difficulty staying focused
  • Strabismus (where both eyes are not aligned)
  • Poor hand-eye coordination
  • Constant squinting/head tilting
  • Using fingers to read
  • Favors one eye over the other
  • Poor handwriting
  • Headaches or fatigue after reading or computer work

Why A School Vision Screening Is Just Not Enough

20/20 just means that one can clearly read the letters on an eye chart that is 20 feet away. There is, however, so much more to good vision than 20/20.

Pediatricians, school vision screenings or certain organizations can detect basic visual aberrations or abnormalities, but the only way to ensure that all the essential visual skills are working properly is to undergo a Comprehensive Vision Exam or a Functional Vision Exam.

The vision screening programs are typically offered by schools, pediatricians or primary care physicians, with the goal of identifying undetected vision problems. If the screening indicates a vision problem, they are then referred to a pediatric optometrist for further, more detailed, evaluation.

These screenings test only for distance visual acuity (myopia). While important, these tests often do not check for farsightedness nor do they verify how well the eyes work together. Even if they do check for these, the superficial nature of these screenings don’t provide any information about eye health and can therefore miss many visual aberrations and conditions.

A comprehensive eye exam, on the other hand, can detect eye diseases and disorders such as glaucoma, cataracts, retinal detachments and macular degeneration, as well as other systemic health problems such as diabetes and high blood pressure.

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Parents And Educators Should Be Concerned About Undiagnosed Vision Issues

Undiagnosed vision problems can cause your child to struggle with school work.

When a child has difficulty reading and doing homework, they can often be misdiagnosed with behavioral or learning problems (ADHD, learning disorders), when in reality, what is truly holding them back is an undetected vision problem.

Eye Conditions That Can Cause School and Work Difficulties


Amblyopia, commonly called “lazy eye,” is decreased vision in one or both eyes despite the absence of any eye health problems. When one eye is weaker than the other, the brain automatically favors the stronger eye and reduces the usage of the weaker eye. This, in turn, causes the weaker eye to become even weaker. Common causes of Amblyopia include Strabismus (see below) and a significant difference in the refractive errors of the two eyes. Developmental optometrists utilize vision therapy, prism glasses, and special software to correct Amblyopia in both children and adults.


Strabismus, also known as crossed eyes, is the misalignment of the eyes, which affects eye positioning and movement. Left untreated, Strabismus can cause Amblyopia in the misaligned eye, double vision, difficulty reading or concentrating on near tasks, exhaustion after homework or reading, and headaches. Depending on the cause and severity, vision therapy is often the right solution for correcting Strabismus. In cases where the condition is caused by weak eye muscles, surgery may be required. In many cases, surgery is combined with vision therapy for the most effective treatment.

Convergence Insufficiency

Convergence Insufficiency is characterized by a decreased ability to converge the eyes and maintain binocular fusion when focusing on near objects. As a result, those with convergence insufficiency experience double vision or a halo effect around words or objects. 

This condition cannot be corrected with eye glasses or surgery. However, vision therapy has been proven to improve eye coordination abilities and reduce symptoms.

Focusing Problems

Our eyes are like a camera, automatically adjusting focus from near, to far, to mid-distance viewing. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again. They may also have difficulty maintaining adequate focus for reading (accommodative insufficiency) or may be slower at adjusting.

Imagine a child looking back and forth from the board to their book, every time losing their place as their vision tries to catch up. Children with focusing or accommodative problems will avoid reading, have trouble focusing on the text, show signs of exhaustion, and demonstrate signs of both physical and visual discomfort when reading. These problems can often be successfully treated with vision therapy.



Eye Tracking

Are both eyes focused and coordinated, working as a team? Poor eye movement and eye tracking abilities can result in poor reading skills, speed, comprehension and concentration. 

Vision therapy can help. 

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Emotional Effects of Vision Problems on Children

Children struggling with eye tracking tend to read at a slower pace than their peers, often losing their place. They often spend more time on tasks than their classmates, causing them to fall behind in their studies.

These kinds of experiences can be emotional frustrating and can spill over into their personal relationships. Feelings of disappointment, irritability, or even failure can lead to resentment of friends, siblings, parents, and educators.

This is why it is so critical to ensure your child undergo a comprehensive eye exam. Just as one requires a complete physical examination to evaluate your overall health, only a comprehensive functional eye examination can assess your overall eye and vision health.

Early detection of potential vision problems can be treated more effectively, giving kids a more positive, happy, and successful academic experience.

Contact Yealy Eye Care's Pediatric Eye Care Center to schedule a comprehensive eye exam, or come to us with your concerns regarding your child’s vision, and we’ll be sure to find the best way to treat his or her visual problems. Let us bring great eye health and vision care to you and your family for many years to come.

Contact us today to schedule a detailed eye exam with Dr. Natalia Yealy.
The staff at Yealy Eye Care's Pediatric Eye Care Center will help ensure that your children get the proper care they need.

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