PEDIATRICS Vol. 23 No. 5 May 1959, pp. 985-989
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OFFICE EVALUATION OF VISION IN CHILDREN

Frank Duncan Costenbader M.D.

I AM PLEASED to be included on a panel discussing the special senses in conjunction with intelligence and certain skills. It would seem that in so grouping these subjects, the eyes, the ears and the other senses have no longer been considered isolated phenomena but as parts of an integrated whole.

It seems important at this early point in the discussion to emphasize the fact that the term "vision" is frequently misused, usually only connoting visual acuity. It should be emphasized that vision in its broadest sense includes visual acuity, the extent of the fields of vision, the normality or abnormality of binocular vision, and the adequacy of the visual associations such as recognition, identification and memory. It seems superfluous to point out that excellent visual acuity, if seen through a gun barrel, is by no means satisfying. Also, that a full, wide field of vision, when the object of interest is blurred, is most unsatisfactory. Having two eyes, each of which is a perfect unit, but not seeing together well and comfortably, is most annoying and handicapping. Finally, referring back to the brain a perfect visual image, which cannot be properly recognized and identified and then correlated with similar images previously received, is a totally frustrating experience.

Thus, for a child "to see well" he must see clearly the thing he looks straight at, he must see widely the things about him, as well as the object of interest, he must have his two eyes properly co-ordinated, and he must be able to recognize, identify and associate this image with related images and activities of the past.