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Do you observe the following behavior(s) in yourself or your child?
Do you observe the following behavior(s) in yourself or your child?
Frequent squinting or closing of one eye?
Frequent squinting or closing of one eye?
Excessive blinking or squinting?
Excessive blinking or squinting?
One eye turns, drifts or aims in a different direction than the other eye? Crossed eye? Wandering eye?
One eye turns, drifts or aims in a different direction than the other eye? Crossed eye? Wandering eye?
(Look carefully -- this can be subtle. This is significant even if it only happens occasionally, such as when the person is tired, stressed or ill).
(Look carefully -- this can be subtle. This is significant even if it only happens occasionally, such as when the person is tired, stressed or ill).
Poor visual/motor skills (including "hand-eye coordination")?
Poor visual/motor skills (including "hand-eye coordination")?
Problems moving in space, frequently bumps into things or drops things?
Problems moving in space, frequently bumps into things or drops things?
Difficulties catching and/or throwing airborne objects?
Difficulties catching and/or throwing airborne objects?
Repeatedly confuses left and right directions?
Repeatedly confuses left and right directions?
Appears to favor the use of one eye?
Appears to favor the use of one eye?
Turns or tilts head in order to use one eye?
Turns or tilts head in order to use one eye?
Posture problems? Head is frequently tilted to one side or one shoulder is obviously higher?
Posture problems? Head is frequently tilted to one side or one shoulder is obviously higher?
While reading or doing close work, do you notice any of the following in yourself or your child?
While reading or doing close work, do you notice any of the following in yourself or your child?
Becomes quickly fatigued?
Becomes quickly fatigued?
Has posture problems?
Has posture problems?
Rubs eyes frequently?
Rubs eyes frequently?
Squints or blinks excessively?
Squints or blinks excessively?
Frequently loses one's place when reading or copying from the board or paper?
Frequently loses one's place when reading or copying from the board or paper?
Frequently skips words and/or has to re-read?
Frequently skips words and/or has to re-read?
Repeatedly omits small words?
Repeatedly omits small words?
Vision becomes blurry?
Vision becomes blurry?
Uses finger to read?
Uses finger to read?
Holds the book or object unusually close?
Holds the book or object unusually close?
Closes one eye or covers eye with hand?
Closes one eye or covers eye with hand?
Twists or tilts head toward book or papers?
Twists or tilts head toward book or papers?
Moves head back and forth (instead of moving eyes)?
Moves head back and forth (instead of moving eyes)?
Struggles with handwriting?
Struggles with handwriting?
Do you or your child frequently complain of:
Do you or your child frequently complain of:
Only able to read for short periods of time?
Only able to read for short periods of time?
Burning or itching eyes?
Burning or itching eyes?
Headaches in forehead or temples?
Headaches in forehead or temples?
Nausea or dizziness?
Nausea or dizziness?
Motion sickness?
Motion sickness?
Double vision?
Double vision?
If you checked off several items on the Checklist above, you should consider a comprehensive vision examinationexamination.
If you checked off several items on the Checklist above, you should consider a comprehensive vision examinationexamination.
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