Like most twins, Bridget and Lisa Isaacs look and act a lot alike. But earlier this year, their mom Liz noticed a slight difference, when Bridget sat down to draw.
"I thought she's tired, end of the day but the doctor said no, she can't see," said Liz Isaacs.
The family discovered what the problem was, when they brought 4-year-old Bridget in for an eye exam.
It revealed her difficulties concentrating had nothing to do with her personality, but everything to do with her eyesight.
"In Bridget's case, she had a condition called amblyopia. One eye was a little more far site than the other eye," said Doctor Elio Polsinelli.
It's a condition also known as lazy eye. Doctor Polsinelli says the condition can lead to long term cognitive issues if it's not caught early. Like a other vision related problems, it can effect a child's performance in school, while going undetected or even misdiagnosed.
"Sometimes a child is diagnosed with add or have a condition called amblyopia, or lazy eye. But they're really far sited, and that can cause them not to be able to pay attention for long periods of time," said Dr. Pollsinelli.
The California Optometric Association is now advocating a state legislation, requiring students to receive a comprehensive eye exam before starting kindergarten.
The group points to a recent study out of UC San Diego, which found that 3-to-5 year olds with vision problems scored lower on a standardized developmental test, but those scores returned nearly to normal after six weeks with the students' vision corrected.
"Eighty percent of what we're learning is through our eyes up to 12 years of age. Then with all those kids not getting eye exams, nine out of 10 children don't get comprehensive eye exam before school. That's huge," said Dr. Pollsinelli.
Only a handful of states have made the exams mandatory.
The American Association of Pediatrics recommends that all children be tested for amblyopia, but doesn't take a position on mandatory screenings, or where they are performed.
Still for patients like Bridget, the early screening was an investment that paid immediate dividends.
"It was almost instantaneous when she got the glasses on, it really was. Now she'll join her sister at the table and color for longer periods," said Liz Isaacs.
A comprehensive vision exam costs about $130 to $150 at a typical optometrist's office. Health plans very in their coverage.