If your first-grade child is having trouble reading or studying; if your preschooler is fidgety when it's time to draw; or your normally coordinated kindergartner can't catch a well-tossed ball, don't presume they're poor students, have early ADD or are merely clumsy. Get their eyes checked.
This is not just about having 20/20 vision. Depending on their heritage, ethnicity, or genetics, it's normal for many young children to have an issue with how well they see. In 2015, that was true for more than 174 thousand children aged 3 to 5 years. I'm nearsighted because my optometrist dad was near-sighted. I needed to wear glasses just before I started first grade and still do. The goal is to catch and correct vision problems in children as early as possible.
Things your eye doctor will screen for include crossed eyes (strabismus), two eyes that see near or far very differently (anisometropia), the ability to see far but not close (hyperopia), or the ability to see close but not far (myopia), and cataracts. Some of these problems can develop later so if your child's grades or behavior start to suffer, have their vision checked by a professional before you start treatment for a learning disability.
Why is it so important to identify any of these problems as soon as you can? Uncorrected vision problems can be a slippery slope. Left unchecked, any vision problems can lead to a more serious common condition called amblyopia, which means a problem with how the eyes work together. Vision is a combination of two elements: how clearly each eye sees alone and how the brain processes the two images. Amblyopia happens when the two eyes see so differently the brain can't figure out how to make them work together so it suppresses the weaker eye. Some people call it lazy eye which sounds like it's the child's fault. It's not. Up to a quarter of young children with vision issues have bilateral amblyopia, which means it affects both of their eyes.
If amblyopia isn't treated in time or properly, then it can cause a severe visual disability, even permanent legal blindness. Don't panic! Early diagnosis and treatment will resolve it. The eye doctor may suggest exercises (vision training), glasses, eye patches, or surgery if necessary.
Based on a series of recent studies published in the Journal of the American Medical Association Ophthalmology (JAMA Ophthalmology) the US Preventive Services Task Force (USPSTF) recommends routine vision screenings for children between the ages of three and five, ideally before they start school. They updated their recommendation because the benefits of early screening greatly outweigh any potential for harm.
What kinds of harm could occur from an early exam? A false positive result, meaning your child is misdiagnosed with one of the visual issues described above when they don't have it, can lead to unnecessary expense and the awkwardness of wearing an eye patch when you didn't need one. A false negative result, meaning your child is given the all-clear when they do have trouble seeing, is as bad as not getting checked at all. That can lead to learning issues, behavioral issues, damage to self-image, as well as the potential for blindness mentioned earlier.
But don't screen too early. Children under the age of three are too young to participate in these types of screenings which require them to answer questions about what they see.
Of course, newborns' and infants' ability to see are routinely checked by your pediatrician during the first year of life. And many simple vision issues are caught during your child's annual checkup when the nurse tests them on an eye chart, but not all which is why it's important to go for an annual eye exam with an optometrist or an ophthalmologist.
The upshot: Learning disabilities might actually be easily remedied vision problems. Don't delay if you suspect that your child is having trouble seeing. Get their eyes checked annually, starting when they're 3 years-old. Here are two helpful vision developmental checklists: one from kidshealth.org and the other from essentialparent.com.