Why a Routine Eye Exam Isn't Enough

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As parents, you want to give your children every opportunity to succeed. When a child struggles with reading, you seek answers - tutoring, speech therapy, and dyslexia interventions are all common steps parents take. However, one crucial factor is often overlooked: your child’s vision. And I don’t mean whether a child can see clearly at a distance, or whether their eyes are healthy.

As a developmental optometrist, I regularly see children who have been diagnosed with dyslexia and ADHD, yet they have never had a functional vision evaluation. Parents often tell me, "My child had an eye exam and they said their vision is fine." What they don’t realize is that a routine eye exam checks only two things:

1. The clarity of eyesight at a distance (20/20 vision)
2. Eye health (checking for diseases)

While these are important, they do not assess the skills required for reading (after all, reading is done up close and not far away). Reading is a complex visual task that requires precise eye movements, accurate eye alignment and focusing abilities, and good visual memory and visualization skills. When these areas are weak, reading becomes difficult, frustrating, and exhausting.

The Hidden Vision Problems That Affect Reading

When a child struggles with reading, it’s essential to evaluate:

1. Reading Eye Movements: Does your child frequently lose their place while reading? Do they skip words or lines? The ability to accurately move the eyes across a line of text is crucial for reading fluency. Some children’s eyes do not move in a controlled, coordinated manner, causing them to reread the same words or even skip over words or whole parts of sentences. Standard eye exams do not test this.

2. Eye Alignment While Reading: Do your child’s eyes work together properly? While reading, the eyes must stay aligned and focused at the same distance for an extended period. Some children experience misalignment issues that lead to eye strain, fatigue, and even doubled vision. Instead of recognizing this as a visual issue, these children are often labeled as inattentive, or that they struggle with comprehension.

3. Visual Sequential Memory: Can your child remember letters, numbers, or words in the correct order? Visual sequential memory is essential for spelling, reading comprehension, and fluency. A child who cannot recall a sequence of words in order may struggle with reading despite strong phonics skills. If a child has difficulty remembering the order of what they see, they will constantly struggle with spelling, recognizing sight words, and following written instructions.

What Happens When These Issues Go Undiagnosed?

When children have undiagnosed visual processing issues, they develop coping mechanisms to get through their schoolwork. They may avoid reading, rely on guessing words, or take far longer than their peers to complete assignments. Often, these children are mistakenly labeled as having attention disorders because they become restless and distracted when faced with reading challenges. In reality, they are simply exhausted from the effort it takes to keep their eyes focused and moving properly.

Unfortunately, because routine eye exams do not assess these critical functions, children with these difficulties are often overlooked. They are told they "have 20/20 vision" and their parents are left searching for answers elsewhere. This is why a specialized developmental optometry evaluation is essential.

How a Developmental Optometrist Can Help

A developmental optometrist evaluates how the entire visual system functions during reading and learning. Unlike a routine eye exam, a developmental vision exam assesses:

If issues are found there are a variety of treatment options that can help improve these skills. Vision therapy for example, is a structured program designed to strengthen eye coordination, tracking, and processing skills. Many children who complete vision therapy see remarkable improvements in their reading ability, confidence, and overall academic performance.

What Parents Can Do

If your child is struggling with reading, here are some steps you can take:



Reading struggles are not always due to dyslexia or a learning disability. In many cases, they stem from an overlooked vision problem that can be treated. By understanding the vital role of vision in reading and learning, parents can take proactive steps to help their children thrive.

Dr Justin Chelette, OD FAAO COEP
Developmental Optometrist at Texas Vision Therapy


Texas Vision Therapy
19002 Park Row Suite 203
Houston, TX 77084

Phone: 832-684-9833
Fax: 346-352-9156
[email protected]

Office Hours
Monday through Friday:
9:00 AM - 6:00 PM

Saturday and Sunday:
Closed

www.texasvisiontherapy.com
www.instagram.com/texasvisiontherapy
www.facebook.com/texasvisiontherapy



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