Refractive Errors

Dr. Burke is one of Cincinnati’s most trusted resources concerning refractive errors in children’s eyes.

Why are children’s visual needs different than adults?

A child’s visual system is in the developing stages till 2 to 3 years old and remains immature (and therefore remains susceptible to amblyopic concerns and fortunately responsive to amblyopic therapies) until around 8 years of age.

Why are glasses prescribed for children?

Glasses are prescribed for children to 1) improve vision, 2) prevent and treat amblyopia (“lazy eye”), and 3) to help straighten eyes that have special types of eye muscle problems. Children with focusing problems such as myopia, hyperopia, and astigmatism may also need corrective lenses.

What are the three types of refractive errors?

Myopia, hyperopia, and astigmatism are refractive errors. Most eyes have similar refractive errors. However, when there is a significant difference in the refractive error between the eyes, this asymmetry is called anisometropia. Anisometropia is one of the main causes of amblyopia in children.

What is myopia?

Myopia, or nearsightedness, is inherited and is often discovered in children when they are 8-12 years old. A myopic eye is longer than normal, causing light rays to focus in front of the retina. This causes close objects to look clear, but distant objects appear blurred.

What is hyperopia?

When light entering the eye is focused behind the retina, we call this hyperopia or farsightedness. A hyperopic eye is shorter than normal. Most young children are normally a little farsighted but have no problems seeing objects up close or at a distance. Hyperopia needs to be corrected in children if it causes decreased vision or were associated with crossed-eyes.

What is astigmatism?

Astigmatism occurs when light rays entering the eye and are focused at different places on the retina. In astigmatism, the cornea may be said to be warped or slightly distorted. Astigmatism blurs vision for both near and far objects.

Are refractive errors considered a disease?

Basic refractive errors are usually thought of as irregularities of the eye and not as diseases. Glasses do not weaken the eyes nor will they cure a refractive error. Glasses are simply an external optical aid that neutralizes or clears the vision. However, there are special situations where refractive errors do play a part in children’s eye problems. In children with amblyopia, glasses are used to help teach the brain to see more clearly. In children with accommodative esotropia, glasses relax focusing effort, which helps the eyes to be straighter.

What happens to refractive errors with growth?

Refractive errors change as the eyes grow. Refractive errors are genetically controlled so similar refractive errors typically run in families. Infants and young children are commonly mildly farsighted. During the pre-pubertal years, typically between 8 and 12 years old, up to 40% of children lose their childhood farsightedness and become nearsighted. This growth related change continues as long as development and maturation continue, typically until 16-18 years old in females and into the early 20s for males. Although there are many areas of research attempting to slow the progression of myopia, there is no consensus on any reliable therapy at this time.

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