Childhood Vision: What the Research Tells Us

Childhood Vision: What the Research Tells Us

What Schools, Parents and Communities Can Do

Schools

Healthy Vision is important for school success.
The first indication of abnormal visual acuity may be identified during school-based vision screening program. 1 School personnel should encourage all students to receive a vision screening or eye exam by the appropriate eye care professional.

Size of print can make a difference.
Choosing books with larger print and teaching reading with larger letter on the wall instead of down on a desk which may be too high for proper distance from eye to book, may help some students. 2

Teachers can help identify children with vision problems.
Because teachers are with students 6 – 7 hours a day, teachers are in a unique position to observe and to detect the first signs of vision problems, such as eyestrain or visual dysfunction. 3 Parents should be notified of problems and a referral to the appropriate eye care professional should be provided.

Vision Skills Needed in School

  • Near vision. The ability to see clearly and comfortably at 10–13 inches.

  • Distance vision. The ability to see clearly and comfortably beyond arm's reach.

  • Binocular coordination. The ability to use both eyes together.

  • Eye movement skills. The ability to aim the eyes accurately, move them smoothly across a page and shift them quickly and accurately from one object to another.

  • Focusing skills. The ability to keep both eyes accurately focused at the proper distance to see clearly and to change focus quickly.

  • Peripheral awareness. The ability to be aware of things located to the side while looking straight ahead.

  • Eye/hand coordination. The ability to use the eyes and hands together.

American Optometric Association. Children’s vision: school-age vision.
Available at http://www.aoa.org.

  Parents

Healthy vision begins early.
The American Academy of Pediatrics recommends all preschool children be screened by age 4 as part of a regular preventive exam. 4 The American Optometric Association and the American Public Health Association also recommend children receive eye exams at early and regular intervals.

Protection of eyes during sports activity is important.
With over 42,000 eye injuries reported to hospitals in a one-year period, parents should provide protective eyewear for children when they are engaged in sports. 5

Vitamin A is important for healthy vision.
Vitamin A comes from animal sources, such as eggs, meat, milk, cheese, cream, liver, kidney, cod and halibut fish oil. The precursor form, beta-carotene, is found in plants. Sources of beta-carotene are carrots, pumpkin, sweet potatoes, winter squashes, cantaloupe, pink grapefruit, apricots, broccoli, spinach, and most dark green, leafy vegetables. These vegetable sources of beta-carotene, unlike most animal sources, are free of fat and cholesterol. A well-balanced diet can provide the necessary nutrients for good eye health. 6

Community

Need for current research is clear.
The most recent national data available on the prevalence of vision problems in children available, the NHIS study, was published in 1983 using 1971–72 data. 7 While small-scale studies are being undertaken, the need for a national large-scale study is apparent.

"Remediation for poor visual skills is as important as remediation for learning failure, because lack of many of these vision skills correlate with learning problems."

Orfield A. Vision problems of children in poverty in an urban school clinic. Their epidemic numbers impact on learning, and approaches to remediation. JOVD. 2001:32:114–141



Glossary of Vision Terms**

Ophthalmology—a branch of medicine specializing in the anatomy, function and diseases of the eye.

Ophthalmologist—a medical doctor who specializes in eye and vision care. Ophthalmologists are specially trained to provide the full spectrum of eye care, from prescribing glasses and contact lenses to complex and delicate eye surgery. In addition to medical school and a one-year internship, all ophthalmologists spend at least three years of residency in a hospital. Some ophthalmologists may sub-specialize in a specific area of eye care.

Optometry—a health care field that specializes in examining, diagnosing, treating and managing some diseases and disorders of the visual system, the eye and associated structures as well as diagnose related systemic conditions.

Optometrist—a health care professional that examines the internal and external structure of the eyes to diagnose eye diseases, systemic diseases, and vision conditions. Optometrists complete pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry. Some optometrists complete a residency.

Pediatric Ophthalmology—branch of ophthalmology that involves the medical and surgical management of strabismus, amblyopia, genetic and developmental abnormalities and a wide range of inflammatory, traumatic and neoplastic conditions occurring in the first two decades of life. This subspecialty also deals with the ocular manifestations of certain systemic disorders.

Refractive Error—a category of vision problems that refers to a loss of visual acuity. The loss of acuity is due to improper light refraction as a result of the shape of the eye. The result is a blurred image. These types of errors are eye disorders.

Vision problems or abnormalities—general term used to describe a broad range of vision related abnormalities that may include correctable conditions such as near and farsightedness, disorders, diseases, impairment, and blindness.

Vision impairment—the measured visual acuity of 20/70 or worse, with correction, in the better eye. Vision impairment means that a person's eyesight cannot be corrected to a "normal" level. It is a loss of vision that makes it hard or impossible to do daily tasks without specialized adaptations. Vision impairment may be caused by a loss of visual acuity, where the eye does not see objects as clearly as usual. It may also be caused by a loss of visual field, where the eye cannot see as wide an area as usual without moving the eyes or turning the head.

Visual acuity—clarity of sight, generally referring to the ability to see things clearly from a specific distance.

** The majority of definitions are from the American Academy of Ophthalmology, American Optometrists Association, National Library of Medicine/Medline Plus, and Centers for Disease Control and Prevention.

References

  1. Yawn BP, Lydick EG, Epstein R, Jacobsen SJ. Is school vision screening effective? J of Sch Health. 1996;66(5):171–175.
  2. Orfield A. Vision problems of children in poverty in an urban school clinic: Their epidemic numbers, impact on learning, and approaches to remediation. JOVD. 2001;32:114–141.
  3. Appelboom TM. A history of vision screening. J of Sch Health. 1985;55(4):138–141.
  4. Wasserman RC, Crost CA, Brotherton SE. Preschool vision screening in pediatric practice: A study from the pediatric research in office settings (PROS) network. Pediatr. 1992;89(5):834–838.
  5. National Injury Information Clearinghouse. U.S. Consumer Product Safety Commission/Directorate for Epidemiology. Product summary report from the national electronic injury surveillance system (NEISS). All products eye injuries CY 2002.
  6. National Library of Medicine. (1/18/2003) MedlinePlus Medical Encyclopedia: Vitamin A. Available at http://www.nlm.nih.gov/medlineplus/vitamina.html.
  7. Ganley JP and Roberts J. Eye conditions and related need for medical care among persons 1–74 year of age, United States, 1971–1972. Vital Health Stat 11(228). 1983.

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