Vision Accommodation In Children

With my son, we were very responsible.  He always went to yearly check-ups, and when he turned five I took him for his vision eye exam.  He had 20/20 vision until 2nd grade, when he was prescribed glasses for 20/25 vision.
I was so excited - maybe this was my answer!  Maybe he just couldn't see well and now he would read!
Nope.  Nothing.  Imagine my disappointment when his attitude toward reading didn't change.  (Not to mention having to buy new glasses every 3 months because he would somehow break the arms off.  You don't even want to know how much I spent on eyeglasses.)
On top of that, he would complain that it was still hard to see with his glasses on.

What is 20/20 Vision?

I am sure many parents are like I was - if my child passed the eye exam, then his vision must be fine.  The vision specialist explained it like this: the standard eye exam just means that your child can see those letters for the 5 seconds he focused on them during the exam.  That's it.
Is it worthless?  No.  Many people do have eye problems that are caught during the standard vision exam, but there are many eye problems that cannot be detected with only that exam.  In order to catch vision problems such as tracking problems, more in-depth testing is needed.
If you suspect your child has a problem, please make an appointment with a vision therapist.  After I found the vision checklist and suspected that this was the problem, I first made an appointment with our eye doctor.  He did an exam and found nothing, but said that it would be a good idea to see the children's vision specialist - even though he didn't think there was a problem.  (He is an excellent optometrist, too.  It just shows you how important an in-depth exam is for discovering these eye problems.)

What is Vision Accommodation?

Accommodation is the eye's ability to focus on objects at different distances.  In order to do this, the eye must change the shape of the lens - just as a camera refocuses when you try to take pictures of objects at different distances.  There are three different abilities of accommodation:

1.  Power - The closer that you can see clearly, the more powerful your accommodation.
2.  Flexibility - How quickly your eye refocuses when shifting its focal point.  (Looking from the board to the book, for example.)
3.  Maintenance - How long you can look at the same distance and stay focused.  (Think about reading long passages.  This problem makes it harder to keep your eyes focused.  My son has this problem.  He starts out great, but his vision gets worse the longer he reads.  At this time, we are up to being able to read for about 5 minutes.)

A student with accommodation problems may struggle to complete work, because his eyes fatigue the longer he tries to stay focused.  Having to take home unfinished work on top of regular homework means that the child may increasingly fall behind, simply because his eyes cannot keep up.
One key to understand about vision problems is that the children don't understand that their vision isn't normal.  That was so crushing for me to realize - my son just didn't understand that not everyone saw things the way he did.  That is why the kids don't speak up - they don't know.  So instead of speaking up they either resist the close work that makes their eyes hurt or they take forever to get it done.  (Guess which one my son did?  Hours and hours of screaming about the work instead of doing it.  Did I mention HOURS?  For years.)

Possible Signs of an Accommodation Problem

1.  The student reads really well at first, but makes sloppy mistakes or loses his place the longer he reads.
2.  She avoids reading or other close work (writing, columns of math problems, etc.)
3.  He mentions headaches when he reads or rubs his eyes frequently.  My son used to say his eyes burned.  (Sadly, the kid has incredibly bad allergies so I never put the burning with an eye problem.  He just did not win the genetic lottery.)
4.  She blinks a lot.  (Blinking is how children try to refocus their eyes when it gets blurry.)
5.  He complains of not being able to see even after having a 20/20 vision screening.
6.  She moves the book around while she reads.  (Imagine moving a book closer or farther away like the lens of a camera.  Again, another another to refocus.)
7.  He makes many careless errors when reading from the board.  (I can't tell you how many times I had to send my son back to his room to recopy his spelling words.  Sometimes I couldn't even figure out what the word might have been.)
8.  She doesn't seem to read as well as she should for her ability.  (I thought my son was just a slacker.  I mean, if I asked him what he should do he could tell me - he just wouldn't do it.  Think of all the kid's labelled "underperforming.")

I am using a wonderful book as my resource for this blog series - our vision therapist gave it to us when we began this journey.  In case you would like to read the book yourself, it is When Your Child Struggles: The Myths of 20/20 Vision by Dr. David Cook.  It is wonderful and easy to read.

Next week I will talk about eye teaming and double vision.

Has anyone else gone through vision therapy with their child?  Teachers, do these signs bring to mind any students?  I could have lit up a room with all the light bulbs that went off in my head when I first learned this!

2 comments

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