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HomeIssues2020 - Winter EditionDO YOU HAVE AN UNDIAGNOSED VISION ISSUE? Take the Quiz



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 

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.

  1. Vision Therapy: Looking Beyond 20/20. Family Matters Magazine: Summer 2019 https://familymattersmagazine.ca/2019/06/vision-therapy-looking-beyond-20-20/
  2. 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



Dr. Laura Cookson
Dr. Laura Cooksonhttp://www.indepthvision.ca
Doctor of Optometry Developmental, Behavioural and Rehabilitative Optometrist. Dr. Cookson completed her Bachelor of Science in Nutritional and Nutraceutical Sciences, with honours, at the University of Guelph. She then went on to receive her Doctor of Optometry degree, with honours, from the University of Waterloo, School of Optometry in 2011. While in school, Dr. Cookson participated in an internship program that traveled around Jamaica, working with the Foundation for International Self Help (FISH). She performed full eye exams all over the country, in both rural and urban settings. Dr. Cookson also participated in an optometric mission trip to Chiapa de Corzo, Mexico, where the team provided free eye exams and glasses to over 1,700 residents. In her final year of optometry school, Dr. Cookson completed an internship focusing on ocular disease at the Jack C. Montgomery Veterans Affairs Hospital in Muskogee, Oklahoma, as well as a pediatric/binocular vision internship in Brampton, Ontario.

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