Pediatric Vision Issues

Pediatric Vision Issues

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"Many parents today are under the impression that the vision screening their children receive from school or the school nurse is sufficient," says Jeffrey R. Anshel, DS, OD. "The screening [at school] will determine the child’s distance vision but what is missing is the near vision. Very few eye screenings include this much-needed exam. Just as children should visit the pediatrician and the dentist, they should also see a licensed eye care provider to screen for vision problems."

Convergence Insufficiency

Children with convergence insufficiency have difficulty moving their eyes inward and using their eyes as a team to comfortably views objects up close. Instead of both eyes comfortable turning inward, the eyes may maintain a more outward stance and sometimes be seen as drifting out when one of the eyes shuts down.  Symptoms of convergence insufficiency may include double vision, headaches, eye strain, and fatigue, loss of place when reading, and decreased attention for near work.  In some cases, children with convergence insufficiency are incorrectly diagnosed with a learning disability or an attention disorder because the symptoms are very similar.

Accommodative Dysfunction

Accommodative dysfunction refers to difficulty using the eyes to maintain clear vision when looking at near objects.  This condition can be exacerbated by or interfere with good convergence skills.  Poor accommodation can also interfere with consistent clarity of vision.

Symptoms of accommodative dysfunction can include:

  • Eye strain, eye fatigue, watery or red eyes.
  • Poor sustained near attention.
  • Avoidance of near work such as reading in school or computers at work.
  • Dizziness, motion sickness or light sensitivity.

Children with accommodative dysfunctions can maintain clear, comfortable near vision for a time, but as the system fatigues, this becomes very hard to maintain and the child usually has to stop reading or gives up on completing the task.

Ocular Motor Dysfunction

Ocular motor dysfunction means that the eyes do not accurately track, move or point to where the child wishes them to go.  Ocular motor dysfunction can interfere with eye-hand coordination, sporting abilities, especially ball sports, and can severely impact reading skills.  Symptoms can include:

  • Difficulty tracking objects
  • Skipping words or inserting or deleting words when reading.
  • Eye-hand coordination as mentioned above.
  • Difficulty with attention or completing assignments.
  • Motion sickness, dizziness or Vertigo.

Treatment of Pediatric Vision Issues

Although glasses may help with these pediatric vision issues, vision therapy is usually the most appropriate treatment.  Vision therapy retrains the eyes to work together, focus appropriately, and track objects.  This may include in-office therapy with special instruments as well as personalized home exercises to practice vision skills. 


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