How a child’s eye care can be linked to their behavior in school

Of course, parents want their children to succeed in school, and when they’re struggling, they may reach out to the child’s doctor or teacher to get them help.  

What may look like learning or behavioral issues might actually be a sign of vision problems. That’s why, as parents consider what might be going on when a child is acting out in school or has poor grades, it may be a good idea to schedule a vision exam.  

If children can’t see well, they may have difficulty reading, writing and participating in activities, according to the American Optometric Association (AOA).¹ “It’s easy to forget that vision plays such a big role in a child’s life. Vision can really impact a child’s behavior,” says Nicholas Onken, O.D., an assistant professor in the School of Optometry at the University of Alabama at Birmingham.  

Read on to discover the ways that poor eyesight may play a role in a child’s learning, how to spot the signs that kids may have trouble seeing, and what to do about it. 

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What types of vision issues might affect kids? 

Kids need to see well in order to do their schoolwork, especially as they get older. Here’s what that may look like:¹  

• The higher their grade, the more challenging their schoolwork may be.
• Their textbooks may have smaller print.
• They may have to complete more homework assignments and tests.
• They may be doing more work on laptops and tablets. 

Here are a few challenges that may affect a child’s vision.  

1. Their eyesight may no longer be 20/20. If a child is sitting toward the back of the classroom, and it’s difficult for them to see the board, it may be more challenging to learn. “When they don’t know what’s going on in class, they may become more disruptive,” says Dr. Onken. Being able to see close up (for reading) and at an intermediate distance (for computer work) may also be important.
2. Their eyes may not work together well. Eyes need to have the ability to focus and track as well   as work together. This is called “teaming,” and it may affect a child’s success in school, notes Dr. Onken. “They can have 20/20 vision, but it doesn’t mean that their eyes work together well as a team,” he says.  

One way to tell if a child’s eyes may not work well as a team? They are quick to learn but read more slowly than normal or have trouble remembering what they read. Parents may notice that their child can only read a couple of pages at a time before needing a break.  
 
“When kids have to work hard to make their eyes point to the same place at the same time during reading, it requires a lot of physical energy. As a result, they don’t have the mental energy left for reading,” Dr. Onken says. 

What’s more, eye teaming issues may also lead to behavioral problems in class. “If it’s difficult for a child to use their eyes, they may also find it difficult to pay attention and may ask for frequent breaks. They may end up talking with their friends more because that’s not a task that requires good tracking of the eyes,” Dr. Onken says. It simply feels better to look anywhere but at the board or a book on their desk.  

1. Their self-esteem may take a hit. Poor vision may affect a child’s self-esteem, which may have long-term impacts on their sense of self-worth as they grow up, says Dr. Onken. “They feel as if they’re different from everyone else and know they’re struggling to achieve because their eyes work differently than their peers,” he says.  

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What might be some of the signs of poor eyesight in kids? 

Sometimes, parents may be able to tell that their child is having vision problems because they’re squinting, but there are other subtle signs that something may be going on with their vision. The following may occur in school, says Dr. Onken: 

• Acting disruptive
• Attention problems
• Having problems with reading
• Reporting headaches
• Saying their eyes are “exhausted” 

It may be a good idea to rule out other issues, too. A child’s behavior or attention problems could be caused by a disorder such as attention deficit hyperactivity disorder (ADHD).² Sometimes, there are 2 things going on. Children with ADHD may also be dealing with vision issues, including eye focusing, teaming and tracking problems, more often than those who don’t have the disorder, Dr. Onken notes.³  

That’s why it’s important to hear from the other health care providers in a child’s life. Parents may also talk to their child’s teacher to understand what’s going on in the classroom. They may also schedule a visit to their child’s health care provider to rule out underlying issues, such as ADHD. They may then want to schedule an appointment with their eye care provider. 

How might parents help with their child’s eyesight?

Even if a child isn’t showing signs of poor eyesight or struggling at school, there may be certain things parents can do to help their kids maintain good vision. Here are some ideas: 

• Encourage smart sight habits. Ask them to practice the 20-20-20 rule when on screens. This means they take a break every 20 minutes to look at something at least 20 feet away for at least 20 seconds.⁴   
• Help them find the time to get outside. “Lots of outdoor time is beneficial for the eyes because research shows that playing outside reduces the risk of myopia, which is also called nearsightedness,” Dr. Onken says.⁵
• Get regular comprehensive eye exams. A vision test is fine, but children need a comprehensive eye exam every year. This means an eye care provider may test a child’s eyes, but they may also dilate their pupils to see into the back of their eyes. They may also see how well the eyes track and work together.  

Children’s vision may change as they grow, so the AOA recommends a comprehensive eye exam before each school year.1 If there’s a change in a child’s behavior at school or parents notice that their child is having issues seeing, it may be a good idea to schedule an eye exam sooner rather than later.  

After all, finding vision problems early and getting them treated may help a child inside and outside of the classroom. 

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Sources: 

1. School-aged vision: 6 to 18 years of age American Optometric Association.
2. What is ADHD? Centers for Disease Control and Prevention, last reviewed September 2023.
3. Association between ADHD and vision problems. A systematic review and meta-analysis Molecular Psychiatry, August 2022.
4. Computers, digital devices and eye strain American Academy of Ophthalmology, August 2023.
5. Time outdoors in reducing myopia Ophthalmology, June 2022.