Vision Problems and Learning Difficulties: What to Watch For

Published on in Health Tip of the Week

Child with glasses in ophthalmologist's office Vision and learning are closely related. Much of what is presented to children in schools is visual. “A child needs clear vision to learn how to read, and needs to keep their vision clear in order to continue learning in the classroom,” explains Ayesha Malik, OD, pediatric optometrist at Children’s Hospital of Philadelphia (CHOP).

There are many aspects to healthy and comfortable vision. Certain ones are particularly important when it comes to learning:

  • Visual acuity. Your child’s vision needs to be clear at different distances — close up for books and papers, at a mid-range for computer screens, and at distance for the teacher’s instructions on the smartboard or blackboard. Some children need glasses to help them see clearly if their focus is too close (nearsighted), too far (farsighted), or not at only one point (astigmatism).
  • Eye focusing. Your child’s eyes need to be able to change focus quickly from far (the front of the classroom) to near (a paper on the desk) and back.
  • Eye alignment and tracking. Your child’s eyes need to be coordinated and able to track together when moving from word to word in a book or on the board at school. A misalignment of the eyes (like eye crossing) can cause poor depth perception and blurred or double vision.
  • Color vision. “Color blindness” is more common in boys. Adjustments may be needed for lessons and tests that require good color discrimination, like in geography and chemistry.

Problems with any of these aspects of vision can lead to symptoms of eye strain, including headaches, fatigue and poor attention. Of course, poor attention could be a problem by itself, unrelated to vision.

Detecting vision problems

Many parents assume that any vision problems will be detected during school vision screenings or by the pediatrician at an annual eye exam. While these tests can help alert to the need for glasses, Dr. Malik says vision screenings don’t always catch more subtle problems.

Inability to focus up close or misalignment of the eyes, both of which can interfere with learning, can be missed by these traditional screenings. If there is a concern at school, a comprehensive vision exam by an eye doctor may be needed.

Identifying vision problems in children can be tricky. Dr. Malik emphasizes that most children do not complain about vision problems because they get by and do not realize their vision could be better. This is especially true if the problem is in just one eye.

Here are some signs to watch for that may hint at a vision problem in your child:

  • Eye squinting
  • Frequently covering or rubbing one or both eyes
  • Eyes that cross or are not straight
  • Head turns or tilts when trying to focus
  • Holding reading material very close or getting very close to the TV
  • Headaches or sore eyes after prolonged reading
  • Frequently losing their place when reading
  • Avoiding reading and other activities that require close-up focus
  • Disinterest in concentrated visual tasks, such as reading or looking at a computer screen for long periods of time

If your child has any of these signs, or a vision problem is detected by your pediatrician or at school, it’s important to have your child examined by an eye doctor who specializes in children (a pediatric ophthalmologist or optometrist).

A comprehensive vision exam with a pediatric eye doctor will test for a wide range of problems that could be affecting your child’s eyesight. The sooner your child’s problem is diagnosed and treated, the sooner they can overcome this obstacle to learning.

Learning disabilities vs. learning difficulties

Dr. Malik notes that there is an important difference between learning disabilities, such as dyslexia, and learning difficulties due to vision problems.

Dyslexia and other learning disabilities are not caused by vision problems. They have to do with the processing of visual information by the brain. In other words, clear images are being sent to the brain, but the disability lies in the processing of that information.

This is in contrast to vision-related learning difficulties. Most vision problems that cause learning difficulties are related to blurry vision or misaligned eyes. These can generally be corrected with glasses or surgery. Once corrected, such vision problems no longer cause learning difficulties.

If you’re looking for options to help your child’s vision-related learning difficulties, you may hear about vision therapy (VT). Apart from one specific condition (convergence insufficiency), scientific evidence does not support the use of vision therapy to improve educational performance.

If your child is having learning problems and no vision problem is detected by a full eye exam, you should talk to your school or pediatrician about a formal assessment for learning disabilities.

Your Child's Ophthalmology Appointment

Find information to help you prepare for your child’s visit to the Division of Ophthalmology.

boy wearing sunglasses

Preparing for Eye Surgery

Is your child having eye surgery at CHOP? Here's what you should know, from scheduling and referrals to how to prepare your child for the procedure.