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Uncorrected refractive error and unsatisfactory performance on several clinical accommodation and binocular vision tests are more common in children who struggle with reading. The aim of the current study is to explore the prevalence of accommodative and binocular dysfunctions in children with and without reading difficulties. Reading performance was assessed with the Acadience Reading (formerly DIBELS Next) test adjusted and validated for the Latvian language. Children with (N = 39) and without (N = 43) reading difficulties underwent thorough assessment of their subjective refraction, as well as binocular and accommodation functions. The results demonstrate no difference in the prevalence of complaints between children with and without reading difficulties (26% and 23%, respectively). However, children with reading difficulties more frequently present with significant uncorrected refractive errors and/or accommodative and binocular dysfunctions than children without reading difficulties (69% and 47%, respectively). According to the findings, even in cases where a child does not exhibit any ocular or visual complaints, a comprehensive visual function evaluation should be required for any child who struggles with reading.