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Are Vision Problems Causing Your Child's Learning Difficulties?


Promoting Healthy Eyes:
Is 20/20 Really Good Enough?

By Dr. Anthony Tran1

While performing an eye exam, I am often asked the question,

“What does 20/20 really mean?” 

It seems that from the vision screenings by the school nurse to the vision testing at the driver’s license office, we have always been taught that “20/20” means perfect vision. 

However, this is not always the case; but rather far from the truth sometimes.

Simply put, 20/20 vision—measured in each eye—means you can see what an average person can see straight ahead at a distance of 20 feet.  

Note that the key words are “straight ahead” and “distance”

While there is no doubt that this part of our vision is critical for a variety of tasks, it does not necessarily encompass everything we do in our daily lives.

From children to adults, there are many common eye disorders and diseases that can go undetected for years because the vision was always measured to be 20/20 and therefore deemed to be “normal”.

Children with signs and/or symptoms of vision problems, like red eyes, tearing eyes, unusual sensitivity to light, eye pain, or squinting should be examined as soon as possible. However, the absence of these symptoms does not necessarily mean the vision is good and their eyes are healthy. 


Children often do not know how they should be seeing because they assume everyone sees the way they do. Because of this, the American Optometric Association recommends that all children receive a professional eye and vision examination at critical stages in their visual development.

These critical stages are:

  • By six months of age
  • At 3 years of age
  • Before first grade
  • Every one to two years until age 18

Allowing vision problems to go misdiagnosed and untreated for years can have far-reaching consequences due to their impact on learning during the critical stages of their development. 


Farsightedness, or hyperopia, is a common problem in children that makes it difficult to focus up close and can result in eye strain and headaches. 

Again, the distance vision may be measured to be 20/20 at a school screening when the problem actually involves the near vision. 

Usually easily corrected with glasses or contact lenses, if left untreated excessive farsightedness can develop into strabismus (crossed-eyes) or amblyopia (lazy eye), in which vision can be permanently reduced. 

Other common problems are related to binocular vision, or the ability of the eyes to work together.  Proper eye teaming, focusing, and following movements are essential for a child to successfully read a book or the computer screen for extended periods of time. 

Unfortunately, children with these types of difficulties are often misdiagnosed as having attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). 

A comprehensive eye examination will help lead to the proper diagnosis.  

Rarer conditions, such as eye tumors and retinal disease, that often do not produce any symptoms can also be detected during the exam.


Parents often ask how very young patients can be examined.

Fortunately, there are many new instruments available today to objectively (i.e., no patient response needed) measure refractive error.

In addition, young children enjoy playing the visual acuity game of identifying common objects on a card like school buses, telephones, and birds that are presented in smaller and smaller sizes.

And most eye health tests, like pupil responses, external examinations, and internal (ophthalmoscopy) examinations only require children to sit still and watch a cartoon to keep their eyes fixated on a distance target.


For children who need to wear prescription glasses, polycarbonate lenses are usually the safest and most durable lens material.

Glass lenses can shatter into dangerous pieces if they are struck by a flying object; and plastic lenses - even with scratch coating - are not as durable as polycarbonate lenses for children.

In addition, if a child plays a rough sport like baseball, basketball, or hockey, goggles such as "Rec-Specs" are wonderful eye safety devices.

In summary, while 20/20 eyesight may generally serve as a good indicator for healthy eyes, it can also give one a false sense of security with regards to a number of eye and vision problems. 

There is no substitute for a regular comprehensive eye examination by your eye doctor because most potential vision loss is preventable if the causative condition is detected early.

Thank you, Dr. Tran, for such

a wonderful article!1

1. Some portions of Dr. Tran's article have been published elsewhere.  He has kindly given permission to use the material and has made exclusive additions and updates to benefit parents and their Afterschool Homeschool vision.

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Dr. Anthony Tran currently practices in Cedar Hill, Texas where he founded Custom Eyes Vision Care

He works with a wonderful staff that is passionate about vision care.

I have listed a few of Dr. Tran’s many accomplishments below.

To learn even more, visit the Custom Eyes Vision Care Website and the Custom Eyes Vision Care Facebook Page.

Dr. Anthony Tran, OD, MBA, FAAO earned his Bachelor of Arts degree in Biology from the University of Texas at Austin and his Doctor of Optometry degree from the University of Houston.  Dr. Tran went on to complete a post-graduate residency program in ocular disease at theSan Francisco VA Medical Center in affiliation with the University of California Berkeley.

Dr. Tran's most recent honors include :

" Best Optometrist" of the Best Southwest area

"Young Optometrist of the Year" by the Texas Optometric Association 

"The Spirit of Entrepreneurship" award by the University of Dallas College of Business.

Dr. Tran is also active in the community, serving on the Board of Directors for the Cedar Hill Chamber of Commerce, providing vision screenings for the Lions Club and no-cost eye exams and glasses for a prisoner outreach program.  

In his spare time, he enjoys spending time with his family, playing golf, and watching football.  Always seeking new ways to make the practice better, Dr. Tran also completed an MBA degree from the University of Dallas Graduate School of Management.

Custom Eyes Vision Care
950 E Belt Line Rd, Suite 190
Cedar Hill TX 75104
Phone: 469.272.EYES(3937)

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