Young Kids Have Eye Problems School Screening Tests Don't Pick Up

One quarter of children 5 and older have problems with their vision, but for many, the problem goes undetected. Many parents don't know that their children have vision problems--problems that might make it more difficult for their children to excel in school.

The Early Show talks to optometrist Andrea Thau, who tells us why comprehensive vision exams are so important for children.

Dr. Andrea Thau is an optometrist, and very active in the movement to make parents more aware of how important it is to test children comprehensively for vision problems. Eighty-six percent of all children under age 5 haven't had a comprehensive eye exam. School and pediatrician's vision screening tests aren't good enough. They typically test only for long-range vision problems and often aren't sophisticated enough to pick up poor eyesight in only one eye.

Most children with vision problems have trouble with close-up vision or have astigmatisms. Both these issues are often not readily apparent with the basic school screening tests.

The American Optometric Association has recommended that parents have their children's eyesight tested with an optometrist or ophthalmologist when they're 6 months old, 3 years old, when they enter kindergarten, and every 2 years after that. Kentucky just passed a law requiring all children entering public school to have an eye exam with an optometrist. Five other states are trying to pass similar laws, and Dr. Thau has been lobbying New York State to pass laws for children's vision tests.

I’ve read that 13% of kids under 5 and 25% of children 5 and older have vision problems. That seems really high. Is that accurate?

Yes, and unfortunately schools screening programs don't detect the problems, and there is little follow-up on what problems are identified. The trend nationwide is to mandate testing before children enter school.

How can you tell that your child might have a vision problem?

Your child may have a problem if she rubs her eyes, squints in sunlight, or if she has ants in her pants but only when reading. If your child has recurrent styes, it might mean that he's rubbing his eyes because of eyestrain.

When do you need to start testing your child’s vision?

At 6 months, then age 3, then age 5 before kindergarten, and then every 2 years after. This is not a pediatrician's screening we're recommending: It's an eye exam.

Is having the pediatrician or school test your child’s vision enough? What’s the difference?

It's like a blood pressure test versus a complete physical. They often screen only for far vision problems, not near. They don't do test tracking. There are many things that they don’t do. That means they can miss serious problems.

What are the most typical vision problems with children?

One of the most common vision failures is being farsighted, which is the failure to see up close These are kids that can see the blackboard fine but get tired when they read. Unfortunately, these kids don't know they have a problem. They think that they are seeing the world as normal, and they don't know it should be easier, clearer. The second most common problem is astigmatism, when the eye is shaped more like a football than a baseball. Some letters will be clearer for some children more than others, which means they can pass a vision screening when there's still a serious problem.

How many states have vision testing laws?

Kentucky is the first one that mandated it. Five states plan on passing it shortly. We just had a press conference in New York to mandate it in New York State.

Who should do the test, an optometrist or an ophthalmologist?

Any eye care professional is fine. Pediatricians are not adequate. There are ophthalmologists that specialize in pediatrics, and they would be good. Most people get their vision checked by opometrists.

What should children expect in an eye exam?

It takes about half an hour. Even for kids who can't read, we have pictures. We sometimes dilate their pupils, have their eyes move, test their depth perception, color vision, eye coordination, focusing. If they're preverbal, we can put lenses in front of their eyes and see if they focus differently. For babies, they are programmed to look at patterns, so if they are offered both a striped and a gray sheet, the baby will stare at the stripe if they can see it, and look all around if they can't make out the stripes.

How much do eye exams cost?

The great news is that most health insurance covers it. And many clinics charge little or nothing, but the range is between $50 and $350.
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