As I mentioned in my last two articles, vision is much more than 20/20. In fact, there are more than twelve visual skills that all come together to make up our vision1. It is the amalgamation of these skills and brain processes that give us the ability to make a meaningful interpretation of what is being seen. Vision is a learned process; we are not born with these visual skills. We develop vision through interaction with our environment.
Vision related difficulties can manifest in many ways, from a child who struggles with school work, reading, or sports, to someone having headaches, light sensitivity, or trouble reading after a concussion. Unfortunately, not all of the symptoms of vision issues are obvious, and consequently, they often go undiagnosed. In fact, one in four children have an undiagnosed vision issue2, and that number goes up to 60% of children with literacy challenges having undiagnosed vision problems2. What makes things difficult is that children rarely complain of vision problems–often, they don’t even know that they see things differently than everyone else. Additionally 90% of traumatic brain injury patients suffer from visual dysfunctions3. This could be from a car accident, fall, stroke, or concussion. In many of these cases, vision is overlooked, when it can be a key factor in rehabilitation.
So how can we tell when an individual has undiagnosed vision issues? The College of Optometrists in Vision Development created a survey to help us spot these cases. Take the survey below to see if you may have an undiagnosed vision issue:
Please assign a value between 0 and 4 for each symptom, based on the frequency with which it occurs. Then, add up your total score at the bottom.
0= never or non-existent / 1=seldom / 2=occasionally / 3=frequently / 4=always
| Blurred vision at near | |
| Double vision | |
| Headaches associated with near work | |
| Words run together when reading | |
| Burning, itching, or watery eyes | |
| Falling asleep when reading | |
| Vision worsening at the end of the day | |
| Skipping or repeating lines when reading | |
| Dizziness or nausea associated with near work | |
| Tilting head or closing one eye when reading | |
| Difficulty copying from a chalkboard | |
| Avoiding reading or doing near work | |
| Omitting small words when reading | |
| Writing uphill or downhill | |
| Misaligning digits or columns of numbers | |
| Poor reading comprehension | |
| Inconsistent and/or poor sports performance | |
| Holding reading material too close | |
| Trouble keeping attention on reading | |
| Difficulty completing assignments on time | |
| Saying “I can’t” before trying | |
| Avoiding sports and games | |
| Poor hand-eye coordination | |
| Poor handwriting | |
| Difficulty judging distances accurately | |
| Clumsiness/ often knocking things over | |
| Poor time management | |
| Disliking change | |
| Frequently misplacing things | |
| Car or motion sickness | |
| Forgetfulness/ poor memory | |
| Total |
Survey courtesy of The College of Optometrists in Vision Development (www.covd.org)
A score of 20 or greater on this survey indicates a high likelihood that you have a vision problem that is affecting your performance in work, school, athletics, and other areas of your life. It is recommended that you see a developmental optometrist for a vision therapy evaluation.
- Vision Therapy: Looking Beyond 20/20. Family Matters Magazine: Summer 2019 https://familymattersmagazine.ca/2019/06/vision-therapy-looking-beyond-20-20/
- Ontario Association of Optometrists https://www.optom.on.ca/
3: Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry 2007;78(4):155-61.
Dr. Laura Cookson
Developmental, Behavioural & Rehabilitative Optometrist
InDepth Vision
61 James Snow Parkway N, Suite 201
Milton, ON
L9E 0H1
Ph: (905) 876-6042
