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Last updated: Mon. Aug. 18, 2014 - 01:25 am EDT

Keeping an eye on kids' vision

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 Back-to-school time can be busy. But there’s one thing parents shouldn’t neglect for their kids’ well-being – an annual eye exam.

Yes, public schools do vision tests. State law requires vision screening in grades 3 and 5 and a more detailed exam when children enterkindergarten or first grade, says Jim Ziemba, director of the Indiana Optometric Association.

But area eye specialists say the tests, while helping many children, often don’t catch kids’ problems in a timely manner, or at all.

“Many parents rely upon a school screening for an eye exam, which is not good. The majority of examinations don’t look in detail at all the vision skills needed for learning,” says Dr. Carl O. Myers, a Fort Wayne optometrist and one of only about 300 in the nation board-certified in vision development.

Myers, of the Indiana Vision Development Center, says 17 separate vision skills are needed for optimum learning, including eye tracking and eye alignment that the typical vision test of reading letters at distance might not reveal.

 “About 80 percent of learning in the classroom is up-close or (relying on) near vision,” he says. “Parents generally notice problems in the sense that the child is struggling in the classroom, but they don’t associate it with a vision problem.”

Dr. Patrice Ellingson of Fort Wayne Family Eyecare says children often compensate for inadequate vision. “They become very good squinters. Or they make excuses so they can walk up to the board (to see it). They don’t realize they could see better.”

Doctors say children should get their first eye exam at 6 months and another at age 3. Annual exams are recommended for school-age children. If a child complains of blurriness or double vision, can’t read moderately distant signs while riding in the car or has trouble naming colors, an appointment is definitely called for, Ellingson says.

What might parents see that might mean a child doesn’t see as well as he or she could?

Lack of coordination. Kids can seem like they bounce off walls, but some kids with vision problems actually do. They also have trouble with sports skills, such as hitting or catching a baseball.

Book avoidance. By toddlerhood, most children will be fascinated by books. Not liking books, even coloring books, may mean a child can’t see their words or pictures. In older children, vision troubles translate into reading problems. Look for using a finger to keep place, skipping lines or words when reading aloud, poor comprehension, trouble copying, poor or crooked handwriting and, as print in texts gets smaller, taking a long time to read or do homework.

Also, if a child doesn’t follow written directions but can follow them orally, a vision problem may be afoot.

Head tilt or postural idiosyncrasies. Children with a lazy eye, an eye turn or one eye weaker than the other often compensate by tilting their heads, contorting their bodies or even shutting one eye to favor their good eye, Ellingson says.

Headaches, fatigue, sleepiness. Working too hard to do vision tasks leads to headaches from strained eye muscles and tiredness. Other physical signals: being overly sensitive to light, rubbing the eyes, blinking excessively or eyes that are dry, red or watery. Car sickness also has been linked to vision problems.

Getting very close to printed material or screens. The stereotypical nerdy kid is often pictured nose-down in a book. But that – and doing the same with a screen – can mean vision trouble. So can sitting close to the TV.

Teacher complaints.  One in 4 children in an average classroom has an undiagnosed vision problem, while among children with learning problems that jumps to 6 out of 10, Myers says.

Adds Ellingson: “There are kids with learning disabilities who have visual problems. And if they (need) a big prescription, they certainly can’t concentrate or focus.”

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