“The pediatrician did a check at their office and says my child’s eyes are fine.” The remainder of this blog post will discuss why just a “check” at the pediatrician’s office is not an acceptable substitute for a complete vision exam.
What is the difference between a vision exam and a vision screening?
A vision screening checks that the eyes are seeing 20/40, which is considered passing by most vision screeners. This is usually what is done at the nurse’s office at school, or at the pediatrician. What does 20/40 mean? It is the ability to read a letter of a certain size from a certain distance under high contrast situations. It tells us nothing about how that information is processed once it gets to the brain or how the eyes work together to gather information. Even someone with “perfect” 20/20 vision can still have processing problems, or difficulty using both eyes together. A screening is not intended to take place of a eye exam completed by an eye professional.
A vision exam is done by an optometrist or an ophthalmologist. We will also check that the eyes are seeing 20/20, but will go in much greater depth and determine what prescription is necessary if they are not 20/20. At each vision exam, we look at how the two eyes move together and work as a team. We check to make sure that both eyes are looking at the same target at the same time (neither eye is turning in or out). We also will complete the dilated portion of the exam to make sure that the eye health is in good order.
I hear that a child had their “eye exam” done at the pediatricians office quite often. While that is a FABULOUS way to screen and catch problems early, it should not be used as a definitive answer. Children every day come into my office who see “perfect 20/20” but still cannot read. These kids likely have a binocular vision disorder, most commonly convergence insufficiency. With upwards of 70% of our waking hours spent looks at things within arms reach it is increasingly important to make sure that our eyes and visual system are equipped to deal with this extra stress. The ability to read an eye chart at a distance only tells us a very small portion of what is happening in the visual system, but a complete vision exam can give us the full picture.