Vision, It’s more than 20/20.

Vision is one area I often see neglected.  My own husband balks at taking our kids to have their eyes assessed just because he does not want them to get glasses. Parents assume the Pediatrician vision assessment is a full assessment and occasionally an extra appointment is one more than some special needs parents can take.  Unfortunately, as an educator, I sometime feel the medical community might fail to suggest glasses because they do not think the child will wear them.  Or periodically, I feel they conclude the vision problem will not effect learning due to the child’s  more pressing problems.   This assumption that a child does not need to see clearly due to cognitive or other issues is one of my biggest pet peeves. 

Did you know the need for glasses can be hereditary.  Did you know 10% of American children under the age of 12 need vision correction.  Did you know about, about 11.5% of the U.S. high school students (1.6 million American teens) may have undiagnosed or untreated vision problems (Prevent Blindness America).

Children with Spina Bifida, especially those with hydrocephalus, even if shunted, are at greater risk for vision problems.  Different children are effected in different ways by hydrocephalus. Many children with hydrocephalus will not have any visual impairment. Others may develop several different conditions of the eyes and vision. These might include: Cerebral Visual Impairment (CVI), Visual Field Loss, Optic Atrophy, Nystagmus or Squint.

Chiari malformations can also effect  the eyes.  Child who have a chairi may experience blurred vision, double vision, sensitivity to light, nearsightedness or nystagmus.

Many parent might not take their child to an ophthalmologist  or optometrist because the child had an assessment at their pediatrician’s office.  The pediatricians assessment typically assess a child’s distance vision. 20/20 is a measurement of how clearly you see in the distance and is only measure of a person’s vision.

Mel was referred to an opthomoligist by her pediatrician.  Mel and Coleman were having well checks at the same time and thus were both sent to the screening area.  Coleman was entering kindergarten and Mel was three.  Coleman went first and as he started indicating the wrong letters, Mel started giggling.  The nurse made a few cute comment to quiet her down.  Coleman failed the test and a formal eye exam was recommended.  Mel was next.  I immediately knew something was up.  Within seconds, she started calling out the wrong letters.  The examiner, once again made a few cute comments, and unfortunately, Mel thought this was funny.  She also failed.  I knew she saw the letters correctly.  I knew she was just playing around.  I went ahead and scheduled a vision assessment for both Coleman and Mel.  I was irritated that Mel was tagging along but figured I might as well get it checked out.  It turns out Mel’s distance vision was fine; however, she could not see close up.    Both Mel and Coleman needed glasses.         Great   😦              Cole could not see far away and Mel could not see close up.

How do you know if you need to get your child’s vision checked.  First ask you pediatrician.  If you or our husband received glasses during your school years, an assessment might not hurt.  In an infant, look for the following: Follows an object with his or her eyes by 5 weeks, brings his or her hands together by 8 weeks, holds and sustains direct eye contact with you by 3 months, turns his or her eyes together to find near objects by 4 months.  Take a picture, the light should reflect off the same place in the child’s eyes.

Mel was initially assessed by a  pediatric opthomoligist, then a few years later, a neuro-optometrist.  I knew these professional check vision in different ways and both are covered under my medical plans. I had her checked initially by a opthomoligist.   Mel went to a Neuro-Optometrist by age 5 years.

Neuro-Optometrists help kids with learning challenges by assessing functional vision.  A child may have functional vision problems if they have problems with tracking, have trouble with visual perceptual, lose their place while reading, point to words while reading beyond age 5, avoid close work, rubs eyes or blinks a great deal while reading, have trouble setting letters on the writing line beyond age 6, cannot copy from a board by second grade and have difficulty catching balls beyond what is expected at each age.

Mel was given glasses to help her see close up at age three.  Prisms were added to her glasses around age 7 as she was struggle to copy from the board and could not catch a ball.  They helped.  The neuro-optometrist indicated her eyes were not working well together.  He also recommended eye therapy but I looked into this and asked Mel’s occupational therapist and pediatrician. Both indicated they did not think vision therapy had enough research to warrant the cost.  When Mel was in ninth grade, I was told due to her shunted hydrocephalus and chairi, Mel’s eyes do not work together.   At that point she was prescribed bifocals.  Mel wears her glasses all the time.  She indicates they make a difference.

Mel also has had ongoing nystagmus for as long as I can remember.  When she is tired it is especially noticeable.  Her eyes move side to side in a wavy pattern.  Mel indicates she cannot even tell they are moving but they move so quickly sometimes its freaky.  Sorry Mel but it is.   🙂

I think Mel’s vision difference are: one reason she has always been a little delayed with ball skills, the reason she did not really enjoy video games that require one to responds to objects moving ie Mario, the reason she enjoys reading but reads slowly and dislikes reading stories on a screen, the reason she was never good at mazes.

My resources

To find a neuro-optometrist
I recommend calling several as prices seem to differ and many want you to do lots of extras that I never found a benefit for-I only do assessments covered by my insurance provider. It’s always good to ask your child’s medical team.


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