Are you worried that your child will be held back? By Dr. S. Moshe Roth   Are you concerned that your child will have to repeat the school year or need to attend summer school? Often a child is held back with the hope that the second time through, a light bulb will suddenly go on. Unfortunately, that usually doesn't happen. When your child struggles with school despite attempts to help, there is a strong possibility that he or she may have a vision problem that is affecting school.This is very different from being able to see letters clearly on an eye chart. As soon as parents and educators hear that a child can see 20/20, they incorrectly assume the child has "perfect vision."  The numbers "20/20" only means is that your child can see the size of letters that are supposed to be seen from a distance of 20 feet. Reading and learning, however, are not done at 20 feet, but rather at 16 to 18 inches - at arm's length. There are many visual skills that are critical to reading and learning, including the ability to track across the page, and to be able to maintain concentration. If a child is missing some of the visual skills they need, reading and learning can become difficult, and at times nearly impossible. Children, however, assume that they are seeing as everyone else is, and rarely complain. There are specific tests and questions to ask in order to determine how a child is seeing. If a child says that sometimes words seem to move on the page, this is a definite indicator that there is a vision problem.A child may say that the words are blurry, they may tilt their head or cover an eye when they read. They may need to take frequent breaks. If your child struggles with reading, it is important for you to know the symptoms of a vision problem. Does your child get frustrated when trying to read or do homework? Does he take much longer doing his/her homework than it should? Does she have a "tracking" problem or have trouble making out words? Does he"forget" to bring homework assignments home? Is it harder to read at the end of the day than in the morning? Does she skip words or repeat lines when reading out loud to you? Does he reverse letters like b's into d's when reading? Does she have a short attention span? If your child has any of these symptoms, he or she may have a vision problem that is correctable, yet eyeglasses are usually not the answer to these problems. Don't make the mistake of assuming that a vision screening is enough to properly find the problem. Your child may still be at risk. A developmental vision evaluation, performed by a developmental optometrist, may be needed to determine that your child has all the visual skills required for reading and learning. This is different than a regular eye exam that addresses eye health and eyeglass issues. Vision skills can be developed. Taking action to solve these problems could make the next school year much easier for your child and for you. For a more indepth symptom checklist or more information about the critical link between vision and learning, visit www.njeyesite.com. Dr. S. Moshe Roth, optometric physician, practices at Family Eye Care, in Old Bridge (license number 463, Therapeutic Certificate TO 413). For more information, call (732) 679-2020.