SYMPTOM QUESTIONNAIRE

 

Observable Behaviors Linked To Vision Problems

 

Do you or your child have any of the symptoms below?

 

Signs of Eye Teaming, Focusing,

and Tracking Problems

 

  • Eyestrain

  • Headaches

  • Double vision

  • Words moving on the page

  • Blurred vision

  • Short attention span

  • Poor reading comprehension

  • Lose place often when reading

  • Cover or close one eye when reading

  • Tired eyes at the end of the day

  • Hold things very close

  • Must use finger or guide to keep place

  • Skip lines and words often

  • Poor/inconsistent in sports

  • Avoid sports/games

  • Poor eye-hand coordination

  • Rub eyes

 

Signs of Visual

Processing Disorders

 

  • Trouble learning left from right

  • Reverse letters and numbers

  • Mistake words with similar beginnings

  • Cannot recognize a repeated word

  • Trouble learning basic math concepts of size and magnitude

  • Poor reading comprehension

  • Poor recall of visual material

  • Trouble with spelling and recognizing words

  • Sloppy writing skills or excessive erasing

  • Trouble copying from the board

  • Can respond orally but not in writing

  • Seem to know material but does poorly on written tests

Any of the above signs or symptoms could be an indication of a hidden vision problem  t hat might hinder academic performance, participation in sports, and comfortable near work.

 

If you are experiencing any of these symptoms, you or your child might benefit from a visual efficiency evaluation and/or a visual processing evaluation.

 

To schedule an evaluation with Dr. Trieu, please visit our contact page.