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During the school year, stress can affect your child’s vision. Sometimes we find that a child with normal eyesight, all of a sudden starts seeing unclearly, for example while reading or performing simple creative actions. Very often, stressful situations at school contribute to the deterioration of the clarity of vision. And what if such condition persists? You should make an appointment with a children’s ophthalmologist and book an orthoptic diagnosis with a certified orthoptist.

Symptoms indicating that stress is affecting your child’s vision:

– they will read particular words backwards (reverse reading): “on” and “no”, “read” and “dear” etc.,

– while reading they will substitute words for those which sound similar, for example: “read” instead of “breed”, “wife” instead of “knife”,

– they will rub their eyes nervously,

– they will leave out certain words or entire lines (verses) while writing or/and reading aloud,

– when reading aloud: for a few minutes they will read at normal speed, fluently, and then all of a sudden start mixing up words and change speed etc.,

– they will pronounce simple words like “hand”, “small”, “yes”, “no”, “on” and “for” incorrectly,

– they prefer books, comics, reading text with large letters and pictures,

– when playing on the computer they will move their heads too close to the screen and take too long to do simple things such as finding a button or an icon etc..

If you notice any of these symptoms we strongly recommend that you make an appointment with a children’s ophthalmologist for an eye test.

How often should a child’s eyesight be checked?

Checks should start early (at 4, 9 and 30 months old). The crucial appointment is the one just before starting school education, as certain emotions accompany this event, connected with a new age in the child’s and parents’ lives. In each consecutive school year (ideally just before the beginning of a new school year) make an appointment with a children’s ophthalmologist and with a certified orthoptist (for an orthoptic diagnosis). Only then will all aspects of vision be “tested” in detail.

What aspects of vision are tested during an orthoptic diagnosis?

During an orthoptic diagnosis the following aspects are tested: convergence, collocation and eyeball movement, accommodation, spatial and three-dimensional vision. For a full picture of the optic functions, an orthoptic diagnosis is necessary – an appointment with a children’s ophthalmologist is not enough!

Symptoms indicating eye defects (for example myopia, hyperopia, astigmatism) appear earlier and are easier to detect but further aspects of the functioning of the optic system are – on the face of it – practically unnoticeable.


How do we move our eyeballs?

With the help of six extraocular muscles: four rectus and two oblique muscles. These muscles keep the eye in a stable position and any irregularity in the functioning of them can indicate problems with vision. Here is a list of the extraocular muscles:

– lateral rectus which draws off the eyeball (i.e. is responsible for sideways movement towards the temple),

– medial rectus which adducts the eyeball (i.e. is responsible for movement towards the nose),

– superior rectus which moves the eyeball up but also adducts it and intorts it (i.e. turns the vertical eye meridian towards the nose),

– inferior rectus which causes interior eyeball movement (down) but also adducts it and extorts it (i.e. turns the vertical eye meridian towards the temple),

– superior oblique causes upward eye movement but also adducts it and intorts it,

– inferior oblique causes downward eye movement but also adducts it and extorts it.

IMPORTANT! Irregularities with the eyeball motor apparatus can only be diagnosed using specialist equipment and under the supervision of a certified orthoptist.

Can the optic motor apparatus (eyeball muscles) function incorrectly due to excessive stress? Yes! Headaches and problems with vision may very often result from a failure of the eyeball muscles to function correctly. When your child is open to stress and negative emotions the fragile optic motor apparatus is automatically affected and problems with vision may occur.

What is an accommodation?

It is the ability of the eyes to adjust when looking at an object while its distance varies.

It happens unconsciously and concerns the contraction of circular beams of the ciliary body muscle. As a result of such contraction the tension within the fibres of the ciliary border on which lens is hung decreases. Thanks to its flexibility it brings out, boots its force (i.e. breaking force) and the eye focuses the beams flowing at close proximity to the retina (i.e. beams running divergently).



Is the breaking force of a healthy eye’s retina steady?

No. It depends on how far away the object we are looking at is. When the eye looks at objects nearby the breaking force of the retina is bigger. When we look things far away this force is smaller.

Ironically, our eye is naturally adjusted to looking at things in the distance, so constantly staring at small objects, reading small fonts and using tablets overload the accommodation mechanism (which leads to accommodative contraction – you can find more on this in our previous post).

Depending on the distance from which we look at a given object, not only the shape of the retina changes but also the shape of the eyeball:

– when we look at objects nearby the lens stands out, so it deflects the rays with more force and the eyeball (eye) extends; the ciliary muscle is tight and the lens’ ligamental system is relaxed,

– when we look into the distance, the lens flattens; it deflects the rays with less force and the eye shortens itself along the anteroposterior axis; the ciliary muscle is relaxed and the lens’ ligamental system tightens up;

When we look at objects close-up for too long, it can result in so-called accommodative spasm.


When are orthoptic exercises recommended? What is the purpose of these exercises?

Orthoptic exercises are recommended when dysfunction occurs within any of the three grades of binocular vision: simultaneous perception, fusion and stereoscopy. They require very accurate measurement of the arrangement of the eye, the condition of binocular vision and the range of fusion, not only before exercises start but also as an ongoing check.


When are pleoptic exercises used?

Pleoptic exercises are used in curing visual impairment. The sooner any visual impairment is diagnosed and therapy starts, the better. A sight defect which is not adjusted may cause “squint eye”. Untreated squint eye causes visual impairment. After the eighth year of life the chances of curing this are significantly smaller.

It is important that the ophthalmologist should be a specialist in child ophthalmology and that the orthoptist should have experience working with children! The diagnosis of problems with eyesight is different in the case of children than it is with adults. An educational approach is needed with the former, along with patience and vast experience for the test to be made correctly and to have the results reflect the actual condition of vision. Regular appointments help to monitor the development of your child’s vision!


We invite you to register for a check up with the children’s ophthalmologist and an orthoptic diagnosis with our certified orthoptist. Contact us on 22 266 09 95. Or write to us at

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We have a fully equipped orthoptic and ophthalmologic clinic:


An orthoptic snail:

orthoptic snail

Contact us before the appointment and we’ll give you directions to our clinic:

tel. 22 266 09 95.