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Fact or Fiction: Does 20/20 vision mean perfect eyesight? Experts say not quite

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Fact or Fiction: Does 20/20 vision mean perfect eyesight?
WATCH: If you have so-called "20/20 vision," you should be able to read a 20 point font, front 20 feet away. But does that necessarily mean you have optimal eyesight? On this week's Fact or Fiction, Noor Ibrahim discusses, – Dec 2, 2020

Do you, or someone you know, often have a hard time reading and spelling? Do you struggle with finding the next line, or keeping the words sharp?

The president of the College of Optometrists of Ontario says this is a very common phenomenon in children, despite often being told they have 20//20 vision.

“About one in 10 of the general population will have this concern to some degree,” said Dr. Patrick Quaid. “But if you look at learning difficulty kids, about seven in 10 will have some degree of eye teaming dysfunction.

“So the amount of people walking around with these things going on is actually quite high.”

If someone has 20/20 vision, that means they can see a 20-point font from 20 feet away. But Quaid says that only describes what’s happening in six per cent of the eye, which doesn’t come close to covering possible issues in “eye teaming”.

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Eye teaming is when your eyes, which see the world from two different angles, work together as a team to produce one clear picture.

So even if you can see well from a distance, if your eyes can’t coordinate with each other, Quaid says you can see words in double, the page can go in and out of focus, and text can even appear like it’s swimming on the page.

There are multiple reasons as to why someone could begin to experience this, but a big one is suffering a severe concussion.

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Eye teaming issues can affect people of all ages. However, Quaid says it’s commonly seen in children with dyslexia or another form of learning difficulty.

But because the child may be able to see well from a distance, the problem can often be brushed off as being a migraine.

Therefore, to a teacher or a parent, the child may seem like they simply don’t like to read, as opposed to actively struggling to see.

“Verbally, these kids are very sharp, but when you put a book in front of them, it’s almost like they crumble,” said Quaid.

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Dr. Coralee Mueller knows all about this.

The optometrist at NeuroVision Therapy Clinic in Peterborough, Ont. says she struggled to read since the age of seven years old.  Even though she could see just fine from a distance, trying to focus on words — or trying to find her place in a book — made her nauseous.

It was only while in college that Mueller got the help she needed, because she simply didn’t recognize the signs before.

Now, she says she sees this all the time with kids coming into the clinic.

“Some of (them) will actually be able to notice,” said Mueller. “Other ones will just feel unwell, their head hurts, their eyes hurt, and maybe get headaches, and they’ll just have some sort of an avoidance or a withdrawal reaction.”

Dr. Quaid says being told you have 20/20 vision “lulls people into a false sense of security,” which might mean that eyesight problems get prematurely ruled out, despite very well being there. The result is the problem remains unaddressed for years.

However, once a diagnosis is hammered down, Quaid and Mueller say there is always hope.

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Both children and adults can undergo optometric vision therapy, which helps retrain the brain to coordinate eye movements together.

“It can make a dramatic difference in a child’s life,” said Mueller.

As for teachers and parents, Mueller said its important to ask a struggling child some very specific questions.

Do the words blur in and out? like are they sometimes clearer than others? Do you find that it’s hard to keep your place? Do you find that its hard to find the next line? Do [the words] double up at all?” said Mueller.

If the answer is yes, Quaid says it might be time to ask for an “optometric vision therapy assessment” from a specialist.

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