School-Aged Vision: 6 to 18 Years of Age

Reading, writing, chalkboard work and using computers are among the visual tasks students perform daily. A child's eyes are constantly in use in the classroom and at play. When his or her vision is not functioning properly, education and participation in sports can suffer.

As children progress throughout their education, they face increasing demands on their visual abilities. The size of print in textbooks becomes smaller and the amount of time spent reading and studying increases significantly. Increased workload and homework place significant demands on the child's eyes and children depend on their vision to function properly so they can learn efficiently and excel.

Vision skills needed for school

Vision is more than just the ability to see clearly or having 20/20 eyesight. It is also the ability to understand and respond to what is seen. There are many basic visual skills beyond seeing clearly that are important to supporting academic success.

Every child needs to have the following vision skills for effective reading and learning:

• Visual acuity—the ability to see clearly in the distance for viewing the chalkboard, at an intermediate distance for the computer and up close for reading a book.
• Eye Focusing—the ability to quickly and accurately maintain clear vision as the distance from objects change, such as when looking from the chalkboard to a paper on the desk and back. Eye focusing allows the child to easily maintain clear vision over time like when reading a book or writing a report.
• Eye tracking—the ability to keep the eyes on target when looking from one object to another, moving the eyes along a printed page or following a moving object like a thrown ball.
• Eye teaming—the ability to coordinate and use both eyes together when moving the eyes along a printed page, and to be able to judge distances and see depth for classwork and sports.
• Eye-hand coordination—the ability to use visual information to monitor and direct the hands when drawing a picture or trying to hit a ball.
• Visual perception—the ability to organize images on a printed page into letters, words and ideas and to understand and remember what is read.

Other visual perceptual skills include:

• Recognition—the ability to tell the difference between letters like "b" and "d".
• Comprehension—"picture" in the child's mind what is happening in a story he/she is reading.
• Retention—remember and recall details of what we read.

If any of these visual skills are lacking or not functioning properly, a child will have to work harder to learn as effectively. Students who struggle with a learning-related vision problem may experience headaches, eyestrain and fatigue. Parents and teachers need to be alert for symptoms that may indicate a child has a vision problem.

Signs of eye and vision problems

When certain visual skills have not developed, or are poorly developed, learning is difficult and stressful. A child may not tell you that he or she has a vision problem because they may think the way they see is the way everyone sees. Children will typically attempt to do the work, but with a lowered level of comprehension or efficiency.

Signs that may indicate a child has a vision problem include:

• Complaints of discomfort and fatigue.
• Frequent eye rubbing or blinking.
• Short attention span.
• Avoiding reading and other close activities.
• Frequent headaches.
• Covering one eye.
• Tilting the head to one side.
• Holding reading materials close to the face.
• An eye turning in or out.
• Seeing double.
• Losing place when reading.
• Difficulty remembering what he or she read.

Undetected and untreated, vision problems can elicit some of the very same signs and symptoms commonly attributed to Attention Deficit Hyperactivity Disorder (ADHD), like hyperactivity and distractibility. Due to these similarities, children eliciting these symptoms should have a comprehensive vision exam with their doctor of optometry to avoid misdiagnosis.

Back-to-school eye exams

A comprehensive eye examination is as essential for back-to-school success as supplies for learning.

Because vision may change frequently during the school years, your child should receive an eye examination every year, or more frequently if specific problems or risk factors exist, or if recommended by your doctor of optometry. Unfortunately, parents and educators often incorrectly assume that if a child passes a school screening, there is no vision problem. The most common vision problem in school-aged children is blurry vision or refractive error caused by nearsightedness (myopia), farsightedness (hyperopia) and astigmatism resulting in blurry vision. However, a child who can see clearly and have 20/20 vision can still have a vision problem relating to eye focusing, eye tracking and eye coordination. In reality, the vision skills needed for successful reading and learning are much more complex.

A vision screening is not a comprehensive exam. Even if a child passes a vision screening, they should receive a comprehensive eye examination. You can read more about the AOA’s evidence-based guidelines for children’s eye exams in this executive summary 

Vision changes can occur without your child or you noticing. The earlier a vision problem is detected and treated, the more likely treatment will be successful. When needed, the doctor can prescribe treatment including eyeglasses, contact lenses, and/or vision therapy to correct vision problems.

Sports vision and eye protection

Indoor and outdoor sports are an enjoyable and important part of most children's lives. Whether playing catch in the back yard or participating in team sports at school, vision plays an important role in how well a child performs.

Specific visual skills needed for sports include:

• Clear distance vision.
• Good depth perception.
• Wide field of vision.
• Effective eye-hand coordination.

A child who consistently underperforms a certain skill in a sport, such as always hitting the front of the rim in basketball or swinging late at a pitched ball in baseball, may have a vision problem. If visual skills are not adequate, the child may continue to perform poorly. Correction of vision problems with eyeglasses or contact lenses or a program of eye exercises called vision therapy can correct many vision problems, enhance vision skills and improve sports vision performance. Eye protection should also be a major concern to all student-athletes, especially in certain high-risk sports. Thousands of children suffer sports-related eye injuries each year and nearly all can be prevented by using the proper protective eyewear.

Regular prescription eyeglasses or contact lenses are not a substitute for appropriate, well-fitted protective eyewear. Athletes need to use sports eyewear that is tailored to protect their eyes while playing their specific sport. Your doctor of optometry can recommend specific sports eyewear to provide the level of protection needed. In addition, many sports are played outdoors, thus it is also important for all children to protect their eyes from damage caused by ultraviolet radiation in sunlight by wearing UV protection grade sunglasses or transition lenses when appropriate.