Critical observation of a child’s eyes and behavior may provide valuable information about the need to refer to his or her primary care provider, regardless of the child’s performance on a routine vision screening test. Ask a coworker, teacher, nurse, or other observer to confirm such signs.

Observing for signs or symptoms of vision problems is part of every vision screen. Even if the distance acuity screening test—or any other test for visual functioning—is passed, observing signs or symptoms of vision difficulty is reason to refer a child to his or her primary care provider. 

Visual Acuity

Experts agree that at least 80% of what a sighted person learns is through vision. Schools, television, and movies all use this knowledge effectively to present ideas to their audiences.

Vision is most commonly described in terms of acuity, or the best a person can see. 20/20 is considered normal vision; while 20/50 prohibits driving in Texas without special aid, 20/70 is called a visual impairment, and when a person sees 20/200 or worse in his or her better eye with the best possible correction on that eye, that person is considered to be "legally blind." A person can see with uncorrectable 20/200 vision, but often too little is recognized to be very helpful.

Relative sizes of objects seen with specific acuities are illustrated by these "E's":

Checklist for Signs and Symptoms of Vision Problems

Appearance of the eyes: 

• Crossed—turning in or out 
• Reddened 
• Watering 
• Encrusted eyelids 
• Frequent styes 

Complaints associated with using the eyes: 

• Clumsiness 
• Headaches 
• Nausea or dizziness 
• Burning or itching of the eyes 
• Blurred vision when looking up from close work 
• Seeing objects double 
• Undue sensitivity to light 

Behavioral indications of possible vision difficulty: 

• Body rigidity while looking at distant objects at any time 
• Thrusting head forward or backward while looking at distant objects 
• Avoiding close work 
• Short attention span 
• Turning of the head to use one eye only 
• Tilting head to one side 
• Placing the head close to the book or desk when reading or writing 
• Excessive blinking 
• Tending to rub eyes 
• Closing or covering one eye 
• Squinting 

The Checklist for Signs and Symptoms of Vision Difficulties can be found in the Forms tab.