By Dr. Karen Chao OD

Parents often mistakenly assume that when a child struggles with reading comprehension, it couldn’t possibly be due to a vision problem.  This is typically because the child can actually read the text out loud.  It may not be read perfectly, but it seems obvious that there is “no problem” seeing the actual letters on the page.

The reason the child can see the words on the page is because the type of vision problems that interfere with reading and learning are intermittent, which means they are not all the time.  Typically we see children who can read fine for about 5 minutes or so but then suddenly can’t remember what was read, even though they read it out loud moments ago.

Words can move around on the page, double up at first and then look single.  While it can be very challenging to read when this happens, one can still read – it’s comprehension and fluency that suffer.

When a student struggles with reading and learning it is important to first rule out the possibility of an eye coordination or eye movement problem.  Most vision screenings in school and even at the pediatrician’s office do not test for these visual skills.  Vision screenings typically test for how clearly one can see the letters on the eye chart (“20/20”) which is only 1 of 17 visual skills required for reading and learning.

According to Dr. Linda Silverman, an educational psychologist who has worked with gifted children for over 40 years, “A high Verbal IQ combined with a Performance IQ that is 20 points lower should signal the need for an optometric evaluation.”  Further, in The Psych 101 Series: Giftedness 101, by Dr. Silverman, it states: “Large discrepancies between VCI (verbal comprehension) and PRI (perceptual reasoning) are often misinterpreted as signs of abnormal brain functioning (e.g., Nonverbal Learning Disorder). Visual processing weaknesses need to be ruled out and visual remedies sought before diagnosing a child with a more serious Nonverbal Learning Disorder (Silverman, 2001).”

Most children think that everyone sees the same way they do, so they don’t know if they have a vision problem or not.  The way they tell you is by their behavior.  Therefore it is vital that parents and educators know the signs and symptoms of a vision problem. The 5 most common signs that a vision problem may be interfering with your student’s academic success are:


  • Skips lines, rereads lines
  • Poor reading comprehension
  • Reading assignments take longer than they should
  • Reverses letters like “b” into “d” when reading
  • Short attention span with reading & schoolwork

If your child has any of the above symptoms, he or she may have a fully correctable vision problem.  Please don’t assume that because the results of the last vision screening were good that your child does not have a vision problem.  If reading is difficult and homework takes longer than it should, be sure your child has all the visual skills required for reading and learning.  For more information, read the children’s vision articles in the Eye Care Articles section of our website: