Reasons to why your child will not wear their glasses:

A child will not wear their glasses reject them for various reasons. One may surprise parents and teachers: The glasses are not the optimal prescription. Once a pair of glasses are prescribed, the person builds their visual system around them. It’s very important to consider the effects the lens prescription will have during their daily activities.

Difference Between Eyesight and Functional Vision

Eyesight refers to the physical capabilities of the eye, such as visual acuity, or the ability to see detail. This can be measured by an eye doctor using an eye chart. Eyesight is often expressed as a number, such as 20/20 or 20/40, with the first representing the distance from the chart and the second representing the distance at which a person with normal vision can see the same letters.

Functional vision, however, refers to how people use their vision in daily activities. It includes seeing and interpreting visual information, such as recognizing faces or reading a book. Functional vision is influenced by factors such as visual perception, visual memory, and visual processing skills. It is not necessarily correlated with eyesight and can vary from person to person, even if their eyesight is the same.

For example, a person may have perfect eyesight (20/20 vision) but have difficulty reading small print due to poor functional vision. Conversely, a person with poor eyesight may have good functional vision if they have learned to compensate for their visual limitations using assistive devices or adaptive strategies.

The Problem: Glasses Not Prescribed for Functional Vision

In many cases, glasses are prescribed to deal with problems related to visual acuity. For many cases in which visual acuity is the only problem, that’s fine.

A child with glasses for nearsightedness might be increasing rapidly due to them overfocusing. Their visual system may become stressed at near each time the prescription is increased to help them see in the distance. Children are rarely just looking in the distance, so the prescription measured to help them see in the distance may have negative effects on the visual system with their up close vision.

How Does an Optometrist Know What Prescription Will Help?

Finding the right prescription starts with conducting the right tests. Eye movements, eye teaming, and eye focusing need to be assessed with and without their new prescription to determine how their visual system will respond to the new prescription. These tests are performed at both the distance and near so lenses can be prescribed at the optimal prescription at both distances. The best prescription may require bifocal or antifatigue lenses.

During the assessment, the doctor may find visual problems not fully corrected by glasses or contact lenses alone. They may also have a binocular vision problem, eye focusing problem, poor eye tracking, or visual processing problem.

Vision Therapy May Need to be Needed

Binocular vision disorders occur when the eyes are unable to work together properly. These conditions can lead to a range of symptoms, including double vision, headaches, eye strain, and difficulty with reading and concentration.

Vision therapy is a type of physical therapy that uses a series of exercises and activities to improve the way the eyes work together. The therapy may involve the use of specialized lenses, prisms, and other visual aids to help train the eyes and brain to work together more effectively.

Some common types of vision therapy used to treat binocular vision disorders include:

1. Eye teaming exercises: These exercises are designed to improve the way the eyes work together, such as focusing on a moving object, tracking an object with both eyes, or converging on an object.

2. Visual processing exercises: These exercises aim to improve how the brain processes visual information, such as identifying objects quickly or distinguishing between different shapes and colors.

3. Eye movement exercises: These exercises improve how the eyes move and focus, such as practicing smooth tracking movements or focusing on objects at varying distances.

4. Balance and coordination exercises: These exercises are designed to improve the coordination and balance of the eyes and body, such as standing on one foot with eyes closed or performing balance drills while wearing special lenses.

The duration of vision therapy can vary depending on the severity of the binocular vision disorder and the individual's response to treatment. Some people may see improvements within a few weeks, while others may need several months of therapy to see significant improvements.

What Should You Do if Your Child Won’t Wear Glasses?

Step 1 - Talk to your child. Ask why he or she isn’t wearing the glasses. Find out if they make your child uncomfortable, such as feeling dizzy or experiencing headaches.

Step 2 - Take the Symptom Checklist. Our website includes a symptom checklist, which is a score-based test to determine if you or your child has symptoms that are typically associated with a functional vision problem. https://www.centerforbetterlearning.com/symptom-checklist

Step 3 - Get a Developmental Vision Evaluation. A Developmental Vision Evaluation requires special training and equipment. You may need to contact a developmental optometrist board-certified by the College of Vision Development (COVD). Their website has a “find a doctor” feature to help you find one in your area.

By not wearing his or her glasses, your child is telling you something. The best way to listen to them is to rule out functional vision problems.