Seeing Eye to Eye

New parents discover that their baby should see a dentist by the time he or she is six months old. But how many parents know that the same standard applies to their child’s vision?  


At six months of age, an optometrist can check for crossed eyes, lazy eye and problems with eye-hand coordination. The next examination should take place at age 3, when a child’s visual system undergoes its most rapid development and vision correction is most effective. 


In some states, children must receive a comprehensive eye exam before entering kindergarten.


Not California.


As schools around the state wrestle with draconian budget cuts and an increasing number of families make do with diminished health care benefits, basic vision care is one of the first things to suffer. 


That’s a serious problem, since undiagnosed and untreated vision problems are responsible for many learning and reading problems among children. 


Many vision problems – tracking, lazy eye, strabismus (eye turns), convergence disorders (eyes that fail to work together) and astigmatism – are easily treated in their early stages. 


We talked to Dr. Elio Polsinelli, O.D., a San Francisco optometrist and member of the California Optometric Association (COA).



I first discovered that my son needed glasses when his fourth grade teacher said he was squinting at the blackboard. Is this the way most parents learn that their kids need glasses?


Unfortunately, yes. Twenty-five percent of children between 5 and 17 have a vision problem – most of which go undetected.


Good vision is more than seeing 20/20. The eyes need to work well together for a child to learn. What seems normal to the child may, in fact, be far off the mark.



What are some red flags for parents to notice? 


It’s rather a long list:


  • Hates or is reluctant to read


  • Frequently loses his place when reading


  • Has difficulty copying from the board


  • Skips little words when reading, but gets big ones


  • Has poor comprehension when reading


  • Writes spaces incorrectly between letters and words


  • Reverses letters like b and d


  • Rubs eyes frequently


  • Sits too close to the TV and/or computer screen


  • Can’t catch or hit a ball when playing sports



What are the ramifications when vision problems go untreated? 


Children with undetected vision problems don’t do well in school. Many act out and become discipline problems. Studies show that 60 percent of children diagnosed as problem learners simply have undetected vision problems. Occasionally, these children are diagnosed as having ADHD or mild autism and given drugs. 


Children labeled as poor learners consider themselves dumb and develop self-image problems that last a lifetime. Vision defects also affect their performance in sports and can inhibit their social skills development. 



The school nurse is a thing of the past. School budget woes inevitably mean overcrowded classrooms. How do you anticipate the new economic reality will affect kids’ overall vision?


Vision screenings by a school nurse help, but they’re not the solution. The school nurse, when one exists, can only test for gross vision reduction. She cannot test for eye diseases, focusing, alignment or tracking disorders, many of which can be corrected if caught in the early stage.


Reports estimate that 40 percent of children who fail an initial screening never receive appropriate follow-up care. It’s important for parents to follow up with appropriate testing by an optometrist. 



Has the economy caused many parents to cut back on preventive health care, including vision exams?


Medi-Cal is available to children in need.  Doctors may offer a courtesy discount or payment plan for the examination.  There are also many organizations like the Lion’s Club that can help.



But what if parents don’t qualify for Medi-Cal? Do you have suggestions for parents caught in the middle?


If you live near an optometry school, such as UC-Berkeley, you should call to inquire about becoming a clinic patient. Students there are closely supervised by experienced professionals, so you can be assured of receiving proper care and treatment.  


Or, visit the office of your local COA optometrist and ask if you can have a brief conversation with the doctor. Explain your situation and ask if it is possible to have your child examined at a reduced rate.  Going directly to the doctor rather than taking it up with the receptionist may produce a better result.


You can find an optometrist in your area at


Sara Solovitch is an associate editor at Bay Area Parent. All three of her sons wear glasses.

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