Today’s guest blogger is Dr. Michael Gallaway.  Dr. Gallaway practices in metro Philadelphia (Marlton NJ).  In addition to his private practice, he has been teaching at Pennsylvania College of Optometry at Salus University since he graduated from the New England College of Optometry.

Most children receive a vision screening in the pediatrician’s office prior to starting school, and later receive some form of vision screening once in school. That’s because vision is so important for learning – up to 80% of what children learn comes through vision.  You would think that screening for vision problems that affect a child’s development or their school performance would be technologically up to date and accurate, but the truth will surprise you!

Most vision screenings use only the Snellen chart, the same letter chart you were probably screened with as a child and which your grandparents were probably screened with when they were children.  The Snellen chart has been used since Civil War times in one room schoolhouses so teachers could know which children should sit closest to the blackboard.  One hundred and fifty years later, and it’s still the only test that most vision screening relies on, even with studies documenting that Snellen charts can miss up to 75% of vision problems. This is because seeing the board clearly is only one of many things children need to do with their eyes in school.  To read and learn, they need the skills to easily focus, move and coordinate their two eyes all day long or else reading becomes a chore…or over time – a learning, behavioral or attention problem.

Another irony is that children who fail the Snellen test are most likely to be nearsighted (or myopic).  But eighty years of research has shown that nearsighted children are more likely to be better readers. The reason?  Children who read more sometimes become nearsighted as their eye muscles adapt to lots of close vision so that their reading requires less focusing effort.  Of course, that can make their distance vision blurry, and so our efforts at vision screening do the best job of finding the children who are the best readers!  Those who are most at risk for a learning related vision problem have eye teaming (binocular), focusing (accommodative), tracking (oculo-motor) and visual processing disorders – and the vast majority have 20/20 vision or already wear eyeglasses!  They see the board easily but struggle using their eyes during reading and writing activities.

When children pass a vision screening by a pediatrician or school nurse, parents, teachers and even the children themselves think their “vision” is fine.  But too many of these children still complain of headaches, double vision or loss of place  when they read or do homework, despite having 20/20 vision.

Recent research has pointed to a potential answer to this dilemma.  VERA is a computer program that screens for both visual acuity (20/20 etc) problems and a range of visual problems that affect reading and homework. This study found that VERA was very effective in finding eye teaming, focusing and tracking problems when compared to standard eye exam tests. One school district that has been using VERA has the lowest special education rate in their county – in part because the school identifies vision problems that are affecting school performance. When these problems are treated with vision therapy or reading glasses, many of the children learn better, and some can even avoid needing special education services…a win-win for children and their schools.  Learn more about VERA at

So don’t assume because your child can read the small letters on the Snellen chart that their vision is fine. Ask your school about how they screen your child’s vision, and whether they know about VERA.  And inquire as to whether your eye doctor checks for the full range of vision issues that affect reading and learning. 20/20 and healthy eyes are important, but they’re not nearly enough.

Dr. Gallaway has no financial interest in VERA or

Read more about vision screenings :

Evidence Supporting the Benefits of Treatment

The Price Tag

Ready For School