Why is there an exception in the phoria referral criteria for first graders?

The exception in the phoria referral criteria for first graders is based on the understanding that their muscle balance abilities are still developing. This stage of development means that their visual system is not yet fully matured, which can lead to temporary imbalances in muscle control when focusing or aligning the eyes. During early childhood, it is normal for children to experience variations in binocular vision as their visual pathways and ocular muscles strengthen and coordinate.

Such developmental changes can sometimes result in misalignment that might not necessarily indicate a permanent issue requiring intervention. As children's visual systems mature, they may naturally outgrow these imbalances. Early referral in these cases could lead to unnecessary anxiety for parents or guardians, as well as unnecessary treatments. Observing and monitoring first graders over time allows for a better understanding of their visual development before making definitive recommendations.