When Good Eyesight is a Privilege, Learning Suffers

A free vision clinic for students. Image via Flickr user Milwaukee Teachers' Education Association.

Last fall, things were not going well in several classrooms at Middle School 223 in the Bronx. One boy in an eighth grade classroom wouldn’t stop bothering the kid sitting next to him—he was constantly being written up for talking in class. A sixth grade girl in the back of the class had yet to utter a word all semester. For MS223, located in the poorest congressional district in the United States, it was just another day of behavior problems and kids who couldn’t seem to be bothered to pay attention. But a week later, everything changed. The boy who couldn’t stop bothering neighboring students suddenly quieted down and began paying attention. The girl who hadn’t said a word started speaking.

The difference? The kids got glasses.

Public schools won’t let kids enroll without an up-to-date medical record, but vision care often gets brushed aside, in large part because people simply aren’t aware that there is a connection between vision, learning, and behavior. Despite the fact that 80 percent of learning occurs through the eyes, only 12 states mandate vision screenings past the fifth grade.

“If you can’t see, you can’t read and you can’t learn,” says Dr. Pamela Gallin, the Director of Pediatric Ophthalmology at New York Presbyterian-Columbia Medical Center in Manhattan, and one of the leaders of a program that provides free eye exams and glasses to students at low-income schools in New York City, including Middle School 223.

According to the American Optometric Association (AOA), vision is one of the primary senses students use as they learn. So an undiagnosed problem can impede a student’s ability to perform adequately across a vast range of areas, from speaking and math to writing and spelling. Eight states don’t require students to get a vision screening of any kind; as a result, many kids with undiagnosed vision problems struggle to keep up in school, especially when it comes to developing literacy skills. The AOA has stated that “25 percent of school-aged children have undiagnosed eye problems that inhibit their ability to read properly,” as reported in the Norwich Bulletin. As students move through the school system, that inability to read fluently quickly ends up impeding progress in every other subject area.

Diagnosing vision problems can be difficult for two reasons. The first, says Dr. Gallin, is that kids often don’t know they can’t see, and they manage to hide the problem well. The second is that vision problems often masquerade as behavioral issues, especially in schools . This was the case for many of the students in the Bronx school. Ashley Downs, the school’s assistant principal, described an eighth grade boy who kept talking to the students sitting next to him, whose behavior improved immediately upon receiving glasses.

“I asked him what happened,” said Ms. Downs. “He explained to me that all of his talking in class was just him asking students near him to read the notes from the board. I asked him why he hadn’t explained this to the teacher, and he told me that he was embarrassed and didn’t want to have to sit in the front row.”

For many students at Middle School 223, less than perfect vision was to blame for both poor behavior and learning delays. The connection between vision and learning was perhaps most stark in two classes of students who were performing at more than four years below grade level. In one class, 10 out of 11 students needed glasses; in the other, nine out of 12 did.

A few tools exist to help educators identify students whose behavior and learning problems are rooted in an underlying vision deficit. VERA (Visual Efficiency Rating), a computerized screening program used in approximately 100 schools or districts, provides test administrators with a checklist of behaviors that could indicate vision problems. These include obvious outward signs of eye issues (“complains of blurry vision”) as well as more oblique behaviors such as poor memory or concentration, cramped writing, and frequent fidgeting. But many schools are unaware that they need to be conducting vision screenings in the first place.

So what can be done? Schools and parents need to take vision screenings as seriously as vaccination requirements, Dr. Gallin says, and parents should routinely have their children’s vision tested. (You can even test your child online here or here.) In some states, programs exist to help catch vision problems before they become learning problems. See Well to Learn, a program in Northern California, aims to screen all at-risk preschoolers in the area annually, and provides free prescription glasses to low-income students. And nationally, the National Center for Children’s Vision and Eye Health helps states to put screening programs in place for young children.

Unfortunately, many students fall through the cracks once they reach their middle school years. Ms. Downs said that while she’d been aware that many students in her school needed glasses, she was shocked by the number of kids who had outdated prescriptions.

“Even when they tested students while wearing glasses, nearly all of those students required new prescriptions,” she says.

Ultimately, parents, teachers, and school administrators need to be made aware of the impact vision problems can have on school performance. Dr. Gallin is currently working to institute a citywide vision screening program in New York, and is also joining forces with other organizations to create an awareness campaign. Which means that hopefully in the near future, more vision screenings will be coming to a school near you.

Interested in breaking the cycle of vision trouble and illiteracy? Get involved with See Well to Learn's flagship Eye Bus program, which brings high-tech vision care through school-based screenings done by certified professionals, follow-up eye exams with optometrists, and free prescription glasses onboard the Eye Bus. Donate or register your child for a screening today.