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Vision and Reading in Children

A Look at Reading and Vision

Getting at the root of reading problems

Because a combination of problems, rather than just one, is usually at the root of a reading difficulty, all possible causes should be explored.


One that is sometimes overlooked is the child's vision. This may happen because the child appears to be able to see, does not complain about his or her eyes, has passed a school vision screening or has not had a comprehensive eye examination.

To See to read: Reading requires the integration of a number of different vision skills: visual acuity, visual fixation, accommodation, binocular fusion, convergence, field of vision, and form perception. Of these, only one is checked by the typical school eye chart test.

Visual Acuity: Visual acuity is the ability to see objects clearly. It is usually the only skill assessed in a school vision screening. The typical school eye chart is designed to be seen at 20 feet and measures how well or poorly the child sees at that distance.

Visual Fixation: Fixation is the skill utilized to aim the eyes accurately. Static fixation is the ability to focus on a stationary object when reading a word or working a math problem.

Accommodation: Accommodation is the ability to adjust the focus of the eyes as the distance between the individual and the object changes. Children frequently use this vision skill in the classroom as they shift their attention (and focus) between their book and the chalkboard for sustained periods of time. Being able to maintain focus at near for sustained periods of time is important for reading, writing and also taking tests.

Binocular Fusion: Binocular fusion refers to the brain's ability to gather information received from each eye separately and form a single, unified image. A child's eyes must be precisely aligned or blurred or double vision, discomfort, confusion or avoidance may result.

Convergence: Convergence is the ability to turn the two eyes toward each other to look at a close object. School desk work is one instance in which a child depends on this vision skill.

Field of Vision: It is important that a child be aware of objects in the periphery (left and right sides and up and down) as well as in the center of the field of vision. Near central or Para-central vision is important for reading ability.

Perception: Visual perception is the total process responsible for the reception and understanding of what is seen. Good visual perception is necessary for successful school achievement.

Treating reading-related vision problems: The optometrist examines these vision skills and determines how well the child is using them together. When a vision problem is diagnosed, he or she can prescribe glasses, vision therapy or both.

Treating reading problems: Because reading problems usually have multiple causes, treatment must often be multidisciplinary. Educators, psychologists, optometrists and other professionals must confer and work together to meet each child's needs.


Pediatric Eye Clinic's goal is to provide our patients with personalized eye health care and education. Our office is equipped with advanced technology allowing us to give you a better understanding and diagnosis of ocular findings. Dr. Gomez is a pediatric optometrist specialized in Wave Design Contact Lenses and Orthokeratology. Orthokeratology or Ortho-k is a non-surgical refractive therapy that helps slow down myopia progression allowing patients to live a life free of glasses or contacts.

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Pediatric Eye Clinic.

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