Here’s looking at you, kid

If a child appears to be struggling in school or performing below his ability, a vision problem could be the cause.

Vision problems that interfere with a person’s ability to learn — learning-related vision problems — may lead to poor school performance and other issues that can ultimately affect the child’s quality of life. Early eye exams are critical for children in order to prevent a misdiagnosis.

The American Optometric Association recommends a child have a comprehensive vision exam by 6 months of age, followed by one at 3 years of age, at 5, and every year that the child is enrolled in school thereafter. An eye exam that tests distance vision is NOT an adequate evaluation of a child’s visual development. A child should have a thorough evaluation by a developmental optometrist, which is an optometrist who specializes in dealing specifically with testing for the visual skills critical to reading and learning, and with diagnosing and treating learning-related vision problems.

A child’s comprehensive eye examination should include age-appropriate testing of the following visual skills:

• Acuity-distance: visual acuity (sharpness, clearness) at a distance of 20 feet.

• Acuity-near: visual acuity for short distance (specifically, reading distance).

• Focusing skills: the ability of the eyes to change focus and maintain clear vision at varying distances.

• Eye tracking and fixation skills: the ability of the eyes to look at and accurately follow an object; this includes the ability to move the eyes across a sheet of paper while reading.

• Convergence and eye teaming skills: the ability of the eyes to aim, move and work as a coordinated team.

• Binocular fusion: the ability to use both eyes together at the same time.

• Stereopsis: binocular depth perception (three-dimensional vision).

• Color vision: the ability to differentiate colors.

At the completion of a thorough evaluation, a combination of glasses, vision therapy, and/or other multi-sensory intervention (occupational therapy, physical therapy, speech therapy, etc.) may be recommended for the child.

What is vision therapy?

Vision therapy addresses the problems listed above that the child may be having and which are interfering with his learning process.

Optometric vision therapy is an individualized treatment program prescribed for a patient in order to:

• Provide medically necessary treatment for a diagnosed visual dysfunction;

• Prevent the development of visual problems; or

• Enhance visual performance to meet the defined needs of the patient.

Optometric vision therapy is an appropriate treatment for visual conditions including an eye turn, a lazy eye, focusing problems, eye-teaming problems, tracking and scanning problems, and visual perceptual disorders.

The systematic use of lenses, prisms, filters, occlusion and other appropriate materials, modalities, equipment and procedures is integral to optometric vision therapy. The goals of the optometric therapy are to alleviate the signs and symptoms, achieve desired visual outcomes, meet the patient’s needs and improve the patient’s quality of life, as defined by the American Optometric Association.

Early diagnosis of a child’s learning-related vision problem can make all the difference in improving that child’s quality of life.

Dr. Ilana Gelfond-Polnariev is board-certified in vision development and vision therapy. She is currently a New York State coordinator for the College of Optometrists in Visual Development and specializes in pediatric vision, vision therapy, and head trauma rehabilitation for children and adults. A 2002 graduate of Pennsylvania College of Optometry, she completed a residency in rehabilitative vision therapy at the State University of New York College of Optometry. She is a recipient of the honorary award for extensive knowledge in behavioral vision therapy, and has published and lectured on children’s vision.

For more information, and to find an optometrist in your area, visit

Dr. Ilana Gelfond-Polnariev [Allied Health Staff at Staten Island University Hospital, 50 Cooper Ave., Staten Island, (718) 979-2020]. For more information, visit

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