Select the symptoms that apply to your child:

Difficulty seeing clearly in the distance

Eyes squinting & frowning frequently

One eye turns in or out constantly or occasionally

Complains of blurry or double vision even occasionally

Fatigue with reading or visual tasks

Headaches after reading or after a school day

Rubs or widens eye when reading

Covers one eye or squints with near work

Works close to the page when reading or drawing

Complains that words move or run on a page

Losing place when reading

Mistakes words when reading quickly

Uses finger or marker when reading

Difficulty copying from the board or from paper to paper

Frequently reversing letters (b, d, z, s)

Transposes words frequently (was, saw)

Choppy reader, poor reading fluency

Slow reader

Cannot remember what is read, poor comprehension

Appears smart but test performance is poor

Misaligns digits in columns

Writing is poorly organised on a page

Avoids reading

Struggles to finish work in class

Homework takes much longer than it should to complete

Is easily distracted

Poor concentration or attention in school

Previously received academic support but is not progressing

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Child's Name

First Name

Last Name

I am interested in booking an appointment for my child, please contact me. *

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My nearest Eyetek Branch is: *

Weltevredenpark

Illovo

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