Normal Vision in Children, and Vision Screening
Most children are hyperopic (farsighted); as long as their eyes focus properly, they should be able to see clearly at near, middle and far distances. Children’s vision should be tested as part of well-child exams, or in vision screenings when they enter school, or whenever a vision problem is suspected. If a learning disability is suspected and tested for, a vision screening and referral for a comprehensive eye exam by an Eye M.D. may also be needed at that time.

Eye Alignment, Focusing, and
Related Problems that Affect Vision

What to do: If any of the following conditions is suspected, the child will need to be examined by an Eye M.D. (ophthalmologist):

Amblyopia
What it is: Amblyopia is a term used to mean poor vision in an eye that has not developed normal sight (usually during early childhood); the condition is sometimes called “lazy eye.”  It occurs when visual acuity is much better in one eye than the other. Amblyopia is common and affects two or three of every 100 people in the U.S.

What to look for:
Strabismus (misaligned eyes)
One eye may look straight ahead while the other turns in, out, up or down.  The eye turn may be constant or may be occasional or intermittent. Signals from the misaligned eye are “turned off” by the brain to avoid double vision, so the child uses only the better-seeing eye. Strabismus effects about 4 percent of children in the U.S.
Other causes: Amblyopia can result from eye problems other than strabismus.  If it seems that the vision in one of the child’s eyes is significantly better (or weaker) than the other, the child needs to be examined by an Eye M.D. (ophthalmologist).

"Cloudy" Eyes
If the surface of the eye, which is normally clear, instead appears cloudy, there may be a cataract or other problem.

Ptosis
This condition involves a drooping upper eyelid that covers the eye either somewhat or entirely, and so blocks vision.

Learning Disabilities and Vision
Learning disabilities include disorders in understanding or using spoken or written language or symbols.

These disabilities result from the brain's misinterpretation of images received and relayed by the eyes, rather than from structural or functional eye problems. That’s why learning disabilities are not treatable by eye exercises or vision therapy. Children with learning disabilities do not have more visual problems than those who do not have learning disabilities.

What to look for: The cchild may experience problems with reading (dyslexia), writing, listening, speaking, concentration, or mathematical calculations. 

What to do: Public schools are required by law to evaluate any child who is thought to have a learning disability; the evaluation should include a complete eye examination by an Eye M.D. (ophthalmologist). Treatment for learning disabilities is best provided through an educational approach, using tutors and resource teachers.  Whether or not learning disabilities are suspected, all students need vision screening to check for visual acuity and general eye health.

Read the July 2009 revised statement on vision and learning disabilities (PDF 192K), issued jointly by the American Academy of Ophthalmology, American Academy of Pediatrics (AAP), the American Association for Pediatric Ophthalmology and Strabismus (AAPOS)  and the American Association of Certified Orthoptists (AACO).