Optometric Checklist for Educators, Parents, and Patients

This checklist of symptoms of visual problems observed at school, at home, and at work will help your optometrist understand how the child/adult performs visually in his daily activities. You can print this out to take with you when you visit your doctor.

Reading

  • Fatigue with reading or comprehension drops with time
  • Confusion of similar words of letters
  • Omits words
  • Short attention span while reading
  • Difficulty keeping place while reading
  • Holds head too close to book
  • Slow reading or word-by-word reading
  • Skips or rereads lines
  • Uses finger or marker as a pointer
  • Avoids reading
  • Says the words aloud or lip reads
  • Difficulty remembering what has been read
  • Reverses words or letters
  • Difficulty remembering newly learned words
  • Poor sitting posture and posision while reading
  • Excessive head turning while reading
  • Frowning, excessive blinking, scowling, squinting, or other facial distortions while reading
  • Rubs eyes during or after reading
  • Tilts head to one side
  • Turns head so as to use one eye only
  • Closes or covers one eye

Writing and Other Desk Tasks

  • Holds head too close to desk when writing
  • Gross postural defects while seated at desk
  • Restlessness while working at desk
  • Difficulty copying from chalkboard or book
  • Squints or blinks looking up at chalkboard
  • Tilts head to one side
  • Turns head so as to use one eye only
  • Omits or repeats letters, words, or phrases
  • Poor eye-hand coordination including poor writing
  • Writes neatly but too slowly
  • Reversals persisting in grade 2 or beyond
  • Weight on the writing arm
  • Does not use other hand to hold paper
  • Immature pencil grip
  • Poor finger movement in writing
  • Draws with short sketchy lines
  • Turns paper to draw lines in different directions
  • Body Posture and Space Awareness
  • Unusual awkwardness
  • Frequent tripping or stumbling
  • Body rigidity while looking at distant objects
  • Thrusts head forward or backward while looking at distant objects
  • Confuses right and left directions

Appearance of Eyes

  • Crossed eyes-turning in or out
  • Watering or bloodshot eyes
  • Red-rimmed, crusted or swollen lids
  • Frequent sties

General Behavior

  • Short attention span
  • Dislike for tasks requiring sustained visual concentration
  • Nervousness, irritability, or restlessness after maintaining visual concentration
  • Inattentiveness, daydreaming
  • Unusal fatigue after completing a vision task
  • Frequent signs of frustration
  • Tension during close work
  • Avoids close work
  • Questions for Children
  • Does your vision get blurry at any time?
  • Can you make it clear?
  • Do you ever see objects double?
  • Do you have headaches, dizziness, or feel sick to your stomach when you use your eyes, or do you get carsick?
  • Do letters and lines “run together” or words “jump”?
  • Do your eyes get tired after reading for a few minutes?
  • Do your eyes ever feel hot or itch?
  • Does light bother your eyes?
  • Do you know where to catch a pop-up fly ball, how far to throw a ball, where the ball is going to be?