Myopia, hyperopia, and astigmatism are common reasons children wear glasses. But what do these terms mean? What causes these conditions? When should you have your child’s eyes checked? Dr. Taressa G. Haney of Charlotte Eye Ear Nose & Throat Associates, P.A. joins us this month to answer these questions and more about your children’s eyesight.
What is myopia? How common is it in children?
Myopia or near-sightedness is when your vision without glasses is better at near than distance. Light rays from a distant object focus in front of the retina, resulting in a blurred image at distance. The prevalence of myopia increases with age and differs according to ethnicity. 
What is farsightedness? How common is it in children?
Hyperopia or far-sightedness in children is normal. The majority of children are hyperopic, and this is a normal state which gives children excellent vision at both near and distance. Children are able to “focus” through the hyperopia to see well at both near and distance. We lose this ability as we age and eventually most adults over the age of 40 need reading glasses to see up close.
What is astigmatism? How common is it in children?
Astigmatism is when the light rays do not focus on a single point on the retina. Astigmatism is caused by variations in the curvature of the cornea and lens. Astigmatism can cause blurred vision at distance and near. Astigmatism can be present at any age.
How are each of these measured?
We can measure the amount of myopia, hyperopia or astigmatism by dilating your child’s eyes. Dilation involves putting drops in your child’s eye that “relax” the focusing ability of the eye. The drops take 20-30 minutes to work. Then we use an instrument called a retinoscope and different powered lenses to measure your child’s prescription. Everybody has a glasses prescription. If your child’s prescription is outside the normal range for their age then glasses will be prescribed. Your child will then have blurry vision for the rest of the day from the eye drops.
How can you tell if your child has any of these conditions, and when should you have a doctor examine them?
If your child is holding reading material close, stating they can’t see very well far away or up close, or is having trouble reading you should have your child examined by an eye doctor. Your child’s primary care doctor will check your child’s vision at each annual well-visit. If they do not pass the screening they will be referred for an eye exam. Schools also perform annual vision screenings.
Even if you don’t notice any signs of vision problems, when should you get your child’s eyes checked, and how often?
Per the 2016 policy statement by the American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Ophthalmology your child will have a vision screening exam at each well visit with their primary care doctor. If your child does not pass the vision screening they will be referred to a specialist (pediatric ophthalmologist). A referral is also recommended for newborn infants with a family history of congenital cataracts, retinoblastoma, or metabolic disease or in whom systemic disease associated with serious ocular abnormalities is suspected. Family history is an important risk factor for amblyopia and strabismus so a referral to a pediatric ophthalmologist should also be considered in children who have first-degree relatives with these conditions. A referral should take place promptly if symptoms or signs are present and, if not, once a child is of sufficient age to cooperate for examinations.
Will these conditions get worse as my child gets older?
Myopia typically increases with age.
Hyperopia typically increases until around ages 10-13, then stabilizes, or decreases. It may not completely resolve, although some children with hyperopia will “out-grow” their need for glasses in the teenage years.
Astigmatism can increase or decrease with age.
How are these conditions treated? Are glasses/contact lenses the only options?
In children, refractive errors (myopia, hyperopia, and astigmatism) are corrected with glasses. The glasses allow the child to see clearly while the glasses are being worn. The glasses will not cause the refractive error to increase, decrease or completely resolve. Also, not wearing glasses will not cause the refractive error to increase, decrease or completely resolve. The glasses simply allow your child to see clearly while the glasses are on and develop good vision in each eye. The critical period for visual development (how well your child can see out of each eye) is under the age of 7. This is the most critical time to make sure that your child has an annual vision screen through their pediatrician’s office or school. If your child has a high or unequal refractive error under the age of 7 that is not corrected with glasses they can develop amblyopia (poor vision in one or both eyes) that can be permanent.
Contact lenses also correct refractive errors and may be appropriate for older children (around age 12) as determined by your eye doctor. If your child wears contact lenses, never let them sleep or go swimming (even with goggles) in contact lenses. Sleeping or swimming in contact lenses puts your child at high risk for a severe type of eye infection called a corneal ulcer.
CEENTA is having its annual back-to-school glasses sale. Any student can receive 35 percent off a new pair of glasses and 50% off a second pair of glasses. Anyone over 18 must present a valid student ID.
Taressa Haney, MD of CEENTA
Dr. Haney is a board-certified pediatric ophthalmologist who sees children ages 0-17 for all eye-related problems. She practices in our Blakeney office, which is located at 5933 Blakeney Park Drive, Suite 200 Charlotte, NC 28277.
Charlotte Eye Ear Nose & Throat Associates
