BEYOND 20/20 SIGHT

My Child Had Their Eyes Tested Already
And They Were Told They Had 20/20 Sight.Why More Testing?

Most basic eye exams look at the physical integrity of the eyes. They focus on eye health, eyesight, and the requirement for glasses.

“If your child's eye exam was under 15 minutes, it is unlikely Visual Efficiency was tested.”

1

Visual Efficiency

The first level of testing is looking at Visual Efficiency. Can the eyes accurately aim together at the right spot and sustain that alignment for the length of time needed? Can they focus clearly and then quickly shift focus from one point to another?

These skills are required for activities such as copying from the board, reading across a page, or keeping one’s place while reading. When Visual Efficiency is weak, the child may experience eye strain, headaches, avoidance of reading, or behaviour that looks like inattention.

2

Visual Information Processing

The next level of vision care evaluates how the individual processes information sent from the eyes to the brain. Visual Information Processing involves skills like tracking, visual memory, visualization, and the ability to understand what is being seen.

When these skills are weak, a child may have difficulty remembering what they read, reversing letters like “b” into “d”, or mixing up similar words. These problems can persist even when standard eyesight checks appear normal.

TESTING INSIGHTS

A general rule of thumb is that if your child’s eye exam was less than 15 minutes, it likely did not include a full Visual Efficiency assessment.

Once we accurately test these skills, we can determine whether vision is playing a role in your child’s learning challenges and design a targeted treatment program.

How Well Could You Read If Print Looked Like This?

These are representations of what it might look like if you had a learning-related vision problem.

“It Makes Sense”

Think about the most common assumption: that the student hears well, sees well, and understands what is being presented. In reality, many children with learning-related vision problems work much harder than their peers just to keep up. If your child is struggling with reading or finding it difficult to keep up with schoolwork, it may be helpful to investigate whether vision is a contributing factor—especially when eyesight tests appear “normal”.
Visual representation of reading difficulty

Video

Optometric Vision Therapy for Learning-Related Vision Problems

Other Frequently Asked Questions By Parents

What Are Learning Related Vision Problems?

Learn how vision problems can interfere with reading, writing and classroom performance even when traditional eyesight appears normal.

Can Vision Therapy Help Children Diagnosed With ADD?

Discover how improving visual skills can reduce visual distraction and support better focus in the classroom.

Why Is Vision Therapy Provided By Optometrists And Not Ophthalmologists?

Learn the difference in training and focus between these eye-care professionals when it comes to functional vision.

What Are Some Signs Of Visually Related Learning Difficulties?

From skipping lines while reading to headaches after homework, certain behaviours can point to vision challenges.

What About The Child Who Is Already Diagnosed With A Learning Difficulty?

Some children benefit from addressing both educational and visual needs to fully reach their potential.

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Frequently Asked Questions

Please reach us at calgaryvisiontherapy@gmail.com if you cannot find an answer to your question.

How do optometry and education complement each other in helping children with reading and learning problems?​

**The Toolbox Analogy**

Imagine that we have delivered to a plot of land all of the necessary raw materials needed to build a house. Piles of wood, nails, screws, drywall, cinder blocks, plumbing supplies, electrical supplies, cabinets, doors, windows and roofing materials are all present in abundance. The child brings to that work site each day their “toolbox”.

In general, schools assume two things. The first is that most children arrive with the set of tools that will carry them through their academic career and that the fundamental set of tools is what a child brings to school as first day of kindergarten. The child is placed into a series of courses such as Carpentry 101, Plumbing 101 and Electrical Systems 101. In Carpentry 101, they are given math skills to make accurate measurements, number facts to be able to count, how to start, drive and set a nail, and making a cross-cut and a rip-cut safely – accurately and square.

Many resourceful and smart children who are missing fundamental tools may find ways to get the job done “some of the time” with the wrong tool. They might find a rock to use as a hammer or they might observe and copy the neighbour hammering. The job often takes longer, the job doesn’t get done well, and they may be scolded for the nail that didn’t go in straight. Vision therapy works on helping children get the right tools in their toolbox.

A student with a diagnosed learning difficulty requiring an Individual Program Plan (IPP) receives a tailored, legally backed, and regularly reviewed document that outlines specific, measurable goals,, accommodations, and, if necessary, curriculum modifications to address their unique learning needs. The IPP serves as a roadmap for support, focusing on strategies that reduce the impact of their disability, such as using assistive technology, extra time for assessments, or specialized teaching methods, ensuring they have equitable access to education.

Key Aspects of the IPP Process for Diagnosed Students:
  • Identification and Assessment: The diagnosis (e.g., LD, ADHD) provides the basis for the special education code, which triggers the development of an IPP, focusing on a student’s strengths and needs.
  • Collaborative Development: Parents, teachers, and specialists work together to set goals, such as improving reading, social skills, or executive functioning.
  • Accommodations vs. Modifications:
    • Accommodations remove barriers (e.g., preferential seating, scribes) without changing the learning outcomes.
    • Modifications adjust the curriculum itself for students who cannot meet standard outcomes.
  • Targeted Support: The plan aims to build self-advocacy skills, allowing students to understand their needs and communicate them as they progress through school.
  • Regular Review: The IPP is a dynamic, living document that is frequently reviewed and updated based on the student’s progress and changing needs.

This proactive approach ensures that, despite their diagnosis, the student has a structured framework for success and equal opportunity in the learning environment.

A child likely needs a comprehensive, functional vision assessment (not just a basic 20/20 eye exam) if they exhibit struggles with tracking, reading, coordination, or have symptoms like frequent headaches and eye rubbing despite passing a school screening. These assessments look for functional, behavioral, and perceptual issues, not just acuity.

Signs Your Child May Need a Functional Vision Assessment:
  • Reading/Learning Struggles: Losing their place while reading, using a finger to guide their eyes, skipping lines, or avoiding reading/homework.
  • Physical Symptoms: Frequent eye rubbing (especially during tasks), headaches, dizziness, or eye strain.
  • Vision Misalignments: Eyes that occasionally turn inward, outward, or do not point in the same direction, which can indicate issues like lazy eye (amblyopia).
  • Behavioral Indicators: Short attention span, poor handwriting, difficulty with hand-eye coordination, or letter/number reversals persisting after age 7.
  • Distance/Near Trouble: Consistently sitting too close to the TV or holding books very close to their face.
  • Physical Signs: A “white reflex” in photographs (similar to red-eye, but white) requires immediate medical attention.

A basic exam focuses on the health of the eye and 20/20 acuity, whereas a functional assessment evaluates how the brain and eyes work together to process information, which is critical if your child is struggling in school despite having “good” vision.

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