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Children’s Vision Quiz

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If your child is not working up to potential in school, there is a strong possibility that a vision problem might be present. Nearly 50% of children with learning difficulties have vision disorders. In most cases these problems can be successfully treated, leading to improved learning and better grades.

You can determine whether your child might have a learning related vision problem by completing the following questionnaire.

 

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If your child has a score greater than 12, it is strongly suggested that an evaluation be done testing those aspects of vision that might be contributing to learning difficulties. If a problem is detected, a Vision Therapy program may be recommended to eliminate the vision disorders.

If your child does not appear to have many of the above signs, and your child has attention problems, struggles with reading, or has an eye turn (Strabismus) or lazy eye (Amblyopia), we recommend you schedule an appointment with one of our doctors.

If your child is doing fine, it is recommended that school-aged children have a routine eye exam by an Optometrist once a year.

 

 

Vision Therapy Assessment Referral Form

  • Section 1: Referring Healthcare Provider

  • Section 2: Patient Information

  • Refraction & BCVA:
  • Refraction & BCVA: