Vision - Beyond 20/20

By James Leonard

As we labor, to educate our children or the students that God has placed under our tutelage, we often feel frustrated that we don’t seem to be accomplishing all we would like. Often the skill development we feel frustrated by is student reading and comprehension ability. The first few years of formal education emphasizes the development of good reading skills. From then on education becomes, in large part, reading to learn. Good reading skills are dependent on good vision.

Vision is a key element in learning.  80% of learning is through the eye. By age 7, vision ought to be well developed for maximum learning success. It has been reported that 21% of the “normal” population have visual problems and 71% of people with reading problems have visual problems. These statistics alone should drive us to consider vision as the prime potential area hindering a student’s development of good reading and comprehension skills.

For the most part good vision is rated by the relative accuracy of letter recognition in various sizes at a distance of 20 feet. Thus it is said that one has good vision (20/20) if they see accurately from 20 feet with each eye. Many eye doctors look at the eyes from this perspective of visual acuity and don’t go much beyond. Sadly the visual difficulties of many children are not that of acuity only. We must look beyond acuity to visual development as a function of fine motor skill development and neurological integration when considering academic difficulties. 

Vision may be the most complex process of the human body in relation to the outside world.   It requires both eyes properly receiving information and transmitting it to the brain. The muscle control of the eye is the most complex and precise muscular activity in the body. When both eyes don’t work well in tandem, academic problems will occur. The problem may be double vision at various distances and circumstances, inaccurate tracking across the page while reading, neural transmission of storage information, visual acuity, or any combination of these and other factors.    

Children don’t know what proper vision is; they only know what they see. They have no standard against which to measure what they see because they may have never seen the world any other way. This was my case, as a double vision problem was not recognized until well into my elementary school years. I was not having academic success, as I could not see properly to be able to move information from the printed page to my brain with ease or accuracy. This problem could have been recognized if someone was observing carefully and asking the right questions.

Over the years I have used a simple screening process to help determine if vision issues concerning muscle control may be a factor in reading difficulties.

To begin a screening session, have the child sit directly in front of you eye to eye. Have a pencil in hand with a large replacement type eraser of a bright color placed on it. The eraser will be the visual target.

To screen for double vision, hold the pencil directly before the child at eye level at a distance of about two feet. Ask how many erasers they see. Next ask them to say “two” when they see two erasers. Then begin to move the eraser closer towards the student with the bridge of their nose as your target point. During this process students often report double vision at various points along the way. At each reporting I ask if they can put the image back together. By watching the eyes carefully you may be able to see the point at which double vision occurs. Characteristically one eye will stop following, or will just veer away from the target. Double vision should not be occurring beyond age 4.  

To screen for tracking issues, begin as before holding the target about two feet from the student asking them to follow it with their eyes not their head. Move the eraser from right to left and back again a few times with a smooth motion keeping it an equal distance from the student. Repeat this at various distances, especially reading distance (about from elbow to hand). As you do this, watch the child’s eyes, observing the eyes’ tracking of the target. Especially watch as you cross the centerline at the nose. It is at this point that the brain switches eyes as to which is controlling the team work that allows smooth tracking when reading across a line on a page or moving back to start a new line. The eyes should move smoothly in unison at all points. Many times the poor reader’s eyes will seem to jump about, trying to get back together and on track. This is very disruptive to reading and comprehension and indicates a need for help.

This list drawn from various sources gives common indicators that vision may be hindering academic progress. Read them and consider them carefully as you observe and question the student.

• Low reading comprehension
• Children who read well but recall poorly may be working so hard visually to accomplish the task of reading that remembering becomes secondary.            
• Vocalization while reading may be being employed to overcome vision impaired
• comprehension; that being a need to hear as another path to the brain.
• If they recall well what is read to them but not what they read, vision may be the issue.
• If they do well in math and concept based activities but poorly in reading comprehension based subjects, vision may be the issue.
• Reports tired eyes, rubbing of eyes, or excessive blinking
• Hard time staying on the line when writing, letter sizes or spacing varies greatly when writing
• Head tilted to one side or unusually up or down, covering or closing one eye
• Moving head rather than the eyes; this should stop by age 8 or grade 2
• Poor distance judgments, reaction time or targeting in sports
• Finger used to track words in sentence or as next line finder
• Loses place on a line, skips lines, repeats words, and confuses letters within a word while reading aloud or to self; which must be determined through careful observation and by asking the right questions.

 Ask all students to read aloud to you regularly; it will tell you much if you listen and watch carefully.

Don’t fail to consider the brain integration aspects relative to muscle control as mentioned in the last article I presented here.

Using these two simple screenings and careful observation of the above indicators could reveal vision related issues. Parents will often say “We just had him to the doctor and he gave him glasses.” Children often need more than glasses to correct vision problems. Vision problems include dysfunctions that cannot be effectively treated by glasses. These are best resolved though various types of vision therapy. Perhaps even surgery as with me, though even in my case surgery may have been avoided had present therapeutic approaches been known back then.

I am not a professional in the area of vision. I am writing this as a concerned teacher, home educator, and person who struggles with vision issues. My desire is to help those laboring with a frustrated student. 

If, after reading this and trying the screenings and observations, you sense vision may be an issue with the child you are considering, please contact a professional. The Optometric Extension Program Foundation Inc. will help you find a Developmental Vision Specialist in your area. Call them at, 949-250-8070, or find them on the web at www.oepf.org.   They have excellent flyers also; I like the one titled “Educator’s Guide to Classroom Vision Problems” and I consider it must reading for all teachers and parents. I have checked with the Optometric Extension Program Foundation, they will gladly send you a copy if you contact them. Another good web resource is www.visionhelp.com   see articles under the topic Vision and Reading.

When we are helping a child and feel lacking, remember the words from James 1:5 “If any of you lack wisdom, let him ask of God, that giveth to all men liberally, and upbraideth not; and it shall be given him.” God wants us to succeed in the tasks he has given us. Ask Him and He will enlighten and direct you.