Many kids who struggle in school have undetected sight problems

When Ben Miller started kindergarten last fall, the 5-year-old at Willard Elementary was struggling to learn.

He could barely write his name and had trouble recognizing all the letters of the alphabet. Whenever his teacher wrote words on the board, the little boy didn’t engage in class discussion. Each time she showed illustrations from a book, Ben couldn’t talk about the details.

Some people might have concluded that Ben had a learning disability. Fortunately, his teacher advised his parents to get his eyes checked.

Up to 25 percent of school-age children may have vision problems that can affect learning, but only 14 percent receive a comprehensive eye exam before starting school, according to 2004 statistics from the College of Optometrists in Vision Development.

The organization also estimates that nearly 10 million kids have undetected vision problems.

Without an eye exam, children who have undiagnosed vision problems are sometimes misdiagnosed as having a learning disorder, according to the American Optometric Association.

And since a significant percentage of what students learn at school is presented visually – particularly in the early grades – kids who can’t see well are automatically at a disadvantage.

Ben’s mother, Kimberly Miller, took him for a comprehensive eye exam at the Spokane Eye Clinic, where she has worked as a patient coordinator for the last 10 years.

They discovered that he had two problems: The boy suffered from hyperopia, or farsightedness, as well as amblyopia, also known as “lazy eye” and one of the most common causes of vision problems in children.

After Dr. Jeff Snow prescribed eyeglasses and the use of a patch to cover his stronger left eye, as well as drops to dilate it during the school day, Ben’s schoolwork quickly improved.

“Ben is a sponge now,” said Miller, who recently met with her son’s teacher during parent-teacher conferences. “He’s seeing everything. His writing is coming along. It’s as if a light has come on.”

Like many parents, Miller never suspected that her son had vision problems. As a preschooler, he would occasionally run into walls, but she attributed his actions to just regular kid behavior.

Ben’s diagnosis was especially a surprise – not just because Miller knew more than the general population about eye care due to her work at the clinic, but also because her husband works as an optician.

“It broke my heart when we caught it,” she said. “But these little kiddos don’t know any different. They’ve never been able to see well so they don’t usually tell their parents that there’s something wrong with their eyes.”

Dr. Stephen Maher, a pediatric ophthalmologist at the Spokane Eye Clinc, advises families to bring their children in for regular comprehensive eye exams beginning at age 4 or 5.

“If we do find something, we have three to four years to improve their child’s vision,” he said.

It’s not enough to get your child’s eyes checked using a 20/20 eye chart at school or during a regular visit to the pediatrician, Maher said. It’s essential that kids also receive a comprehensive eye exam, which includes specialized testing and evaluation of all visual skills.

Most parents, however, don’t realize there’s a difference between vision screening and comprehensive eye exams. As a result, many families who skip the preventive care end up coming to the Spokane Eye Clinic only after they’ve detected signs of a vision problem.

The average age for children coming in for their first visit is 8 or 9, Maher said.

“The eyes’ connection to the brain is pretty much set at the age of 8,” he explained. “If we are able to detect a problem early and treat it, then we can get their vision improved so that they can have two working eyes.”

It’s also essential that parents and other guardians follow the treatment plans that he and other doctors prescribe for their children, Maher stressed.

Maher is one of a handful of ophthalmologists in the region who specialize in the eye care needs of children.

Each year, the Spokane Eye Clinic serves more than 3,000 youths ages 16 and under from throughout Eastern Washington and North Idaho. The clinic was founded in 1955 by Maher’s father.

While Maher suggests that kids begin regular eye exams at age 4 or 5, parents with younger children who suspect that their children might have vision problems should bring them in right away, he said.

In addition to taking their children in for regular eye exams, parents should pay attention to eye safety, Maher said.

He has treated kids who have accidentally poked themselves in the eye with a stick or who suffered eye injuries while pretending to have a sword fight with other children. His own son, when he was 7, once hurt his eye with a barbed hook on a fishing pole.

Kids also should be taught to never look directly at the sun, Maher said. And those who are light sensitive should wear sunglasses.

In recent years, he and other eye specialists are treating more injuries related to sports, particularly paintball.

According to the American Academy of Ophthalmology, more than 42,000 eye injuries from sports and recreation were reported in the United States in 2000, with more than 70 percent involving people younger than age 25.

A study published in the journal Pediatrics also noted that eye injuries caused by paintball rose from about 545 in 1998 to more than 1,200 in 2000, and that more than 40 percent of the injuries happened to children.

That’s why Maher and other doctors recommend that everyone, especially kids, wear protective eyewear when playing paintball.