Vision: It’s Not Just Your Eyeballs

Can children who see 20/20 still struggle with vision?

This is a question many parents ask when they first visit Vision Services at A Chance To Grow. 

Believe it or not, vision is more than the limited concept of seeing clearly, or seeing 20/20.

The 7 Components of Vision:

  1. Seeing clearly with both eyes (this is 20/20)
  2. Seeing singly with both eyes 
  3. Seeing comfortably with both eyes 
  4. The ability of the eyes to work together as a team at a variety of distances 
  5. The ability of the eyes to gather information 
  6. The ability of the eyes to process and integrate information 
  7. The brain's ability to understand and respond to what the eyes gather 

Vision is a set of learned skills that allow us to obtain meaning and understanding from what we see. Again, 20/20, or seeing clearly, is only one of these skills. Oftentimes, vision is thought of as something that happens only in the eyeball. But in reality, it takes the entire brain and body to have strong vision. When it’s solely the concept of the eyes seeing clearly, that is sight, not vision.

Many schools measure vision based solely on clarity of sight in distance using a Snellen chart. Therefore, the other six components addressed above, as well as near acuity, are not checked during most school exams. This means that even though a child might score 20/20, the exam does not address the other six components of vision, leaving the child to struggle if there are weaknesses in the other areas.

Skilled developmental optometrists can tackle these many components of vision through vision therapy, or a combination of vision exercises that improve visual functioning, development and processing skills. However, because vision is a whole-body skill, certain steps must be taken before deciding if vision therapy is the best route.

First, it must be determined whether or not the child is experiencing any balance, vestibular, bilateral coordination, or primitive reflex issues. These areas, which involve overall brain-body awareness, actually play a key role in a child’s vision development and functioning. Delays in development in any of these areas greatly affect a child’s ability to take in visual information efficiently.

For example, delays in the development of balance and vestibular skills can affect eye movement skills. Also, poor bilateral coordination skills or retained primitive reflexes can negatively affect focusing or eye teaming (the ability of the eyes to move as one). Specific vision therapy techniques can be used to improve these developmental skills.

If your child sees a developmental optometrist and the testing indicates that significant delays in development might be present, then the next step may be to turn to an Occupational Therapist (OT) to receive an evaluation of your child’s needs and a recommendation for next steps.

Once an OT addresses your child’s delays in brain-body awareness, it might be determined that your child is no longer in need of vision therapy because the OT exercises solved the overriding development issues affecting your child’s vision. Or, the OT will determine that vision therapy is the next step and you can move forward and begin work with a Developmental Optometrist.

Vision therapy has been known to improve vision comfort, reading speeds, accuracy, comprehension, the ability to copy and take notes and even athletic ability when approached in the correct way.

Have more questions or interested in talking to Vision Services at A Chance To Grow?




Congratulations on writing a good article.

Enjoyed reading your blog. I am constantly amazed at the connection between our primitive reflexes and natural human development.

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