Vision Therapy: Undiagnosed Vision Issues - Family Matters Magazine - Winter 2019

Author: Dr. Laura Cookson | | Categories: Emergency Eye Care , Eye Clinic , Eye Doctor , Eye Exam , LASIK Co-Management , Lazy Eye Treatment , Myopia Control , Neuro Vision Rehabilitation , Optometric Care , Optometry Clinic , Pediatric Eye Exam , Senior Eye Exam , Sports Vision Enhancement , Strabismus Treatment , Syntonic Therapy , Vision Rehabilitation of Traumatic Brain Injury , Vision Therapy for Amblyopia


As I spoke about in my last two articles, vision is much more than 20/20. In fact, there are more than 12 visual skills that all come together to make up our vision1. It is the amalgamation of these skills and brain processes that give us the ability to make a meaningful interpretation of what is seen. Vision is learned, we are not born with these visual skills. We develop vision through interaction with our environment.

Vision related difficulties can manifest themselves in many ways from a child who struggles with school work, reading, or sports, to someone having headaches, light sensitivity, or trouble reading after a concussion. Unfortunately not all of the symptoms of vision issues are obvious, and often they go undiagnosed. In fact, 1 in 4 children have an undiagnosed vision issue2, and that number goes up to 60% of children with literacy challenges having undiagnosed vision problems2. What makes things difficult is that children rarely complain of vision problems, as they don’t know that what they are seeing isn’t how everyone else sees. Additionally 90% of traumatic brain injury patients suffer from visual dysfunctions3. This could be from a car accident, fall, stroke, or concussion. In many of these cases vision is overlooked, when it can be a key factor in rehabilitation.

So how can we tell when an individual has undiagnosed vision issues? The College of Optometrists in Vision Development created a survey to help us spot these cases. Take the survey below to see if you may have an undiagnosed vision issue:

Please assign a value between 0 and 4 for each symptom, based on the frequency with which it occurs. Then add up your total score at the bottom.

0= never or non-existent / 1=seldom / 2=occasionally / 3=frequently / 4=always

Blurred vision at near


Double vision


Headaches associated with near work


Words run together when reading


Burning, itching, watery eyes


Falling asleep when reading


Vision worse at the end of the day


Skipping or repeating lines when reading


Dizziness or nausea associated with near work


Head tilt or closing one eye when reading


Difficulty copying from a chalkboard


Avoidance of reading or near work


Omitting small words when reading


Writing uphill or downhill


Misaligning digits or columns of numbers


Poor reading comprehension


Inconsistent and/or poor sports performance


Holding reading material too close


Trouble keeping attention on reading


Difficulty completing assignments on time


Saying "I can't" before trying


Avoiding sports and games


Poor hand-eye coordination


Poor handwriting


Difficulty judging distances accurately


Clumsy, often knocking things over


Poor time management


Does not like change


Tends to lose things or belongings


Car sickness/motion sickness


Forgetful, poor memory




Survey courtesy of College of Optometrists in Vision Development (

A score of 20 or greater on this survey indicates a high likelihood that you have a vision problem that is affecting your performance in work, school, athletics, and other areas of your life. It is recommended that you see a Developmental Optometrist for a Vision Therapy evaluation.


  1. Vision Therapy: Looking Beyond 20/20. Family Matters Magazine: Summer 2019
  2. Ontario Association of Optometrists
  3. Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry 2007;78(4):155-61.


Dr. Laura Cookson

Developmental, Behavioural & Rehabilitative Optometrist

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