1.1 - Functional Vision Exams vs. Traditional Eye Exams: Why 20/20 Isn’t the Whole Story

Lisa Raad
Jul 15
2 min read

Updated: Oct 8

You saw an Optometrist and they've said your vision is perfect? or your child passed a school vision screening. Great, right?

But if reading is still a battle or headaches keep piling up, the problem might not be eyesight. It could be your functional vision.

Imagine buying a car based on how shiny the paint is—but never checking the engine. That’s what happens when we rely on a traditional eye exam alone. While it might confirm you can see clearly (20/20), it doesn’t tell you if your eyes work together, focus efficiently, or track accurately.

This first post in our Functional Vision Series dives into the key differences between a functional vision exam and a basic eye test - and why millions of people are being misdiagnosed or underserved.

What is a Functional Vision Exam?

A functional vision exam evaluates how your eyes perform in the real world - not just how clearly they see a letter chart. It checks critical skills like:

Eye teaming (binocular vision)
Focusing flexibility (accommodation)
Eye tracking (oculomotor control)
Depth perception
Visual processing speed
Visual-motor integration

These are the behind-the-scenes players that impact reading, writing, balance, coordination, and even emotional regulation.

How It Differs from a Traditional Eye Exam

Traditional Eye Exam	Functional Vision Exam
Checks eyesight (20/20) and eye health	Evaluates how eyes work together and focus
Looks for diseases like glaucoma or cataracts	Assesses skills used in reading, learning, movement
Typically 10–20 minutes	Often 45-60 minutes with interactive testing
Conducted by an Optometrist or Ophthalmologist	Performed by an Orthoptist or Behavioral Optometrist
Often bulk-billed	Mostly out-of-pocket, but worth the insight

📊 A study in the Journal of Behavioral Optometry found that more than 60% of children with learning difficulties had at least one undetected functional vision problem despite having 20/20 vision.

Who Needs a Functional Vision Exam?

Children with unexplained reading or learning issues
Adults with persistent headaches, dizziness, or motion sensitivity
Anyone recovering from concussion or brain injury
Students who hate reading or frequently reverse letters
Professionals experiencing screen fatigue or productivity dips

These issues often masquerade as ADHD, dyslexia, or anxiety—but the root cause may lie in a dysfunctional visual system.

Quote to Remember

“Seeing 20/20 doesn’t mean you have perfect vision. It just means you can see the chart - what you do with that vision is what really matters.”— Dr. Robert Sanet, OD, Vision Therapy Leader

Final Thoughts

A functional vision exam can uncover the hidden issues that are quietly holding you or your child back - issues that won’t show up in a standard eye test.

It’s not about finding a new prescription. It’s about unlocking your full visual potential.

If learning feels harder than it should, or your eyes are constantly working overtime, a deeper exam could change everything.