Vision Screening for Preschoolers
Waking each morning to the sight of the sun touching the earth with its wide array of colors is something that is often taken for granted. When vision is impaired -- especially in young children -- waking to a world where everything is a blur and colors are unclear can be very frustrating. Small children may not understand why they can't see things and often lose interest in reading, writing or playing. This is one of the reasons why early vision screening is so important.
Preschoolers depend upon their vision to learn tasks that will help ready them for school. Areas such as reading, learning to write and recognition of colors, shapes, letters and numbers can be affected if there is a vision problem. "Impaired vision may prevent a child from retaining interest in areas such as story time or coloring," says Dr. Liviu Saimovici, an optometrist for the Advance Eye Care Associates of New York. "As the interest in these areas fades due to vision difficulty, so does the level of education and learning."
Approximately 48 percent of all children have or will have some type of vision problem before reaching the age of 8, according to the American Academy of Optometrists. These vision problems may be due to an illness and will last only a few weeks or months or may be due to a genetic trait and may last their entire lives. Due to the variation of vision development in preschoolers, the AAO recommends that children receive at least one vision screening prior to school enrollment and continue to receive vision screening annually unless there is an indication of vision problems.
Children who are experiencing vision problems may exhibit inappropriate behaviors in frustration, anger or fear. These behaviors may include defiance; outbursts of anger; throwing books, pencils or crayons; self-isolation or even signs of depression. As the behaviors are a result of a child's emotions, parents are encouraged to approach their children with love and concern in an attempt to discover if vision difficulty is the root cause. "If a parent becomes frustrated with the child in return, the situation can escalate," says Saimovici. "This should be avoided as it could mask or hide the reasons behind a child's behavior as it relates to vision difficulty."
"My son wouldn't even let me read to him," says Karen Winniski, a mother from Chicago, Ill. "My husband and I would tuck him into bed at night and ask what book he wanted to read. He would usually say he didn't want a story. If we did read to him, he would turn toward the wall and not even look at the pictures. At the age of 4, you would think he would still want us to read to him, but he didn't. I knew something had to be wrong."
Is There A Problem?
Usually, preschool staff will help in detecting a problem with a child's vision and offer screenings throughout the year. However, if a child does not attend preschool the detection of a potential vision problem is then left up to the parents. "Parents can be tricky about it without letting the child know they are 'testing' them," says Saimovici. "Asking a child to look at something across the room while sitting at the dinner table to see if he/she can find it or if they squint to see it is one way a parent can 'test' their child. If a child does look at books or can recognize colors or shapes, making a homemade eye chart can also offer clues to the parents as to whether or not a child may have a vision problem."
Testing for preschoolers is done in a way that helps place the child at ease. As the letters are replaced with pictures, shapes and objects, the characters the children are asked to identify are very common and well known. "Some pediatric optometrists will make the visit fun to help put the child -- and the parents -- at ease," says Saimovici. "The children may state that they see a cow on the screen and soon the room will be filled with 'moos.' It's a simple process and one that can help eliminate various stresses and frustrations for the children and their parents."
In addition to frustration, fear and anxiety related to vision problems, parents may also find their child suffering from headaches while attempting to read, color or draw. "My daughter would get headaches almost daily," says Renee Wheeler, a nurse's assistant from Columbus, Ohio. "She was in daycare for about six hours a day during the week. Each day when I would pick her up, she would begin telling me about her day and then inform me that she had another headache. When I asked her doctor about it, he asked me if I had ever had her vision checked. I hadn't done it to that point, but within a week she went to see an eye doctor."
One Parent's Experience: Donna Wolf, mother of two from Evanston, Ill.
"I was shocked in preschool when my daughter Leah (then 4) came home with a note saying she failed a vision screening. Indeed, we went to a pediatric ophthalmologist who said Leah had severe astigmatism in both eyes. Astigmatism makes everything blurry, and kids who have it are usually born with it -- it doesn't develop. The good news is it usually doesn't get worse.
"I asked the doctor how strict I should be about making Leah wear the glasses. Her response was, 'Once she puts them on, she won't take them off.'
"When we saw her glasses and the degree of correction, I cried. The whole world had been a complete blur to her for all her years and we never knew. She didn't sit close to the television or squint or hold books very close ... because that wouldn't make it any better. She gave no clue that I could tell that she had any trouble. That was just the way the world was to her.
"I believe not being able to see much for those first years affected her personality. She was always cautious about entering into new situations. Not clingy, just observing a long time before joining in. I thought she was just sort of sizing things up socially. Now I realize she was just trying to see what was going on. Her fine motor skills got better at this point, too.
"I think vision screening should be a part of pediatric exams. We had all our checkups. Thank G-d she was in preschool, or we wouldn't have found out until kindergarten. I don't know why the doctor didn't test. She only would ask if we noticed any problems and since we didn't, she didn't.
"Getting the vision screening was worth the price of preschool. I will always feel indebted to them for that."
After a Diagnosis is Made
Once a vision problem has been diagnosed, the next step may be glasses. As small children fear being teased or made fun of, it is important for a parent to ease their child's mind and let them find glasses that they feel comfortable with. "Children know what they like," says Saimovici. "Parents should allow a child to pick their own glasses since they will be the one who is wearing them. Also, parents can help their child feel comfortable with their new glasses if they let the child know how good they look, how special the glasses are and how well they will be able to see with them."
Young children may not understand why they can't see well and may be frightened to tell anyone due to fear of what what's to come. Using subtle methods, explaining the process as it unfolds and allowing the child to ask questions can help in relieving that fear while they make their way to seeing all the world has to offer. "Vision problems are common in both children and adults," says Saimovici. "Letting a child know how special they are, regardless of how they see, will take the focus off of the problem and place it back on the child."