Feb272025

Recognising Refractive Errors in Children: Myopia, Hyperopia, and Astigmatism

Imagine a child squinting at the board in class, struggling to read their favourite storybook, or frequently rubbing their eyes after homework. While these may seem like small habits, they could indicate an underlying vision problem. Refractive errors in children are among the most common vision disorders, yet they often go unnoticed until they affect their academic performance and daily life.

This blog explores paediatric refractive errors, their causes, symptoms, and treatment options. It emphasises the importance of early detection in ensuring healthy visual development. If you’ve ever wondered how to ensure your child’s vision develops correctly, this guide will answer.

What Are Refractive Errors?

Refractive errors in children occur when the shape of the eye prevents light from focusing directly on the retina. This leads to blurry vision at different distances. The most common types are:

1. Myopia (Nearsightedness)

Children with myopia can see nearby objects clearly but struggle with distant vision. This condition has become increasingly common, often linked to prolonged screen time and reduced outdoor activities.

2. Hyperopia (Farsightedness)

Hyperopia causes difficulty in seeing nearby objects, though distance vision may remain unaffected. The eye can compensate in mild cases, but significant hyperopia can lead to eye strain and headaches.

3. Astigmatism

Astigmatism results from an irregularly shaped cornea or lens, causing blurred or distorted vision at all distances. Children may experience difficulty reading, frequent eye rubbing, or headaches.

Symptoms of Refractive Errors in Children

Detecting paediatric refractive errors can be challenging, as children may not realise they have vision issues. Common signs include:

  • Squinting or tilting the head
  • Frequent eye rubbing or blinking
  • Holding books or devices too close
  • Complaints of headaches or eye strain
  • Difficulty focusing in class
  • Avoiding reading or close-up activities

Causes of Refractive Errors

Several factors contribute to refractive errors in children, including:

  • Genetics – A family history of myopia, hyperopia, or astigmatism increases risk.
  • Eye growth abnormalities – The cornea’s shape and length of the eyeball affect how light focuses on the retina.
  • Lifestyle habits – Excessive screen time and limited outdoor activities are associated with an increased risk of myopia.

Diagnosis: Identifying Refractive Errors

A comprehensive paediatric eye exam is the best way to detect refractive errors early. School screenings and paediatric check-ups help, but only an ophthalmologist can provide an accurate diagnosis.

Eye tests may include:

  • Visual acuity test – Reading letters on a chart to measure clarity.
  • Refraction test – Using a phoropter to determine the correct prescription.
  • Retinoscopy – Shining a light into the eye to observe how it reflects off the retina.

Treatment Options for Paediatric Refractive Errors

The right refractive error treatment depends on the type and severity of the condition. Options include:

1. Prescription Glasses

Eyeglasses are the most common and effective solution. They help children see clearly and reduce strain.

2. Contact Lenses

While generally recommended for older children, contact lenses can be an option for those engaged in sports or prefer them over glasses.

3. Vision Therapy

In some cases, this therapy may help with conditions like accommodative issues but does not cure refractive errors.

4. Myopia Control Treatments

Specialised glasses, contact lenses, or atropine eye drops may help slow myopia progression in children.

Why Early Detection Matters

Undiagnosed refractive errors can impact a child’s academic performance, leading to frustration and a lack of confidence. Poor vision may also affect coordination in sports and daily activities. Early detection and treatment ensure children develop essential visual skills for learning and interaction.

The Role of Genetics and Lifestyle

While genetics play a role, environmental factors also influence refractive errors in children. Encouraging outdoor play, limiting screen time, and ensuring proper lighting while reading can help reduce strain and slow myopia progression.

Preventive Measures for Better Eye Health

  • Ensure regular eye check-ups from an early age.
  • Encourage outdoor activities for at least 2 hours a day.
  • Maintain a balanced diet rich in vitamins A, C, and E for eye health.
  • Follow the 20-20-20 rule – every 20 minutes of screen time, take a 20-second break by looking 20 feet away.

Special Considerations for Young Children

Young children may not express vision problems clearly, so parents should observe for any signs of difficulty. If a child frequently rubs their eyes, tilts their head, or struggles with hand-eye coordination, it’s best to consult a paediatric ophthalmologist.

When to See a Paediatric Ophthalmologist

If a child shows signs of refractive errors or has a family history of vision problems, it’s important to schedule an eye exam as early as possible. Experts recommend:

  • First eye exam: At 6 months of age
  • Second eye exam: At 3 years old
  • Before school starts: Around age 5 or 6
  • Regular follow-ups: Every 1-2 years or as advised by the ophthalmologist

FAQs

1. What are the early signs of refractive errors in children?

Squinting, headaches, holding objects close to the face, and difficulty reading can indicate vision problems.

2. Can refractive errors be outgrown, or do they last a lifetime?

Some mild cases of hyperopia improve with age, but myopia and astigmatism typically require long-term management.

3. Is excessive screen time responsible for refractive errors?

While screen time doesn’t directly cause refractive errors, it can contribute to eye strain and myopia progression.

4. What are the treatment options for paediatric refractive errors?

Eyeglasses, contact lenses, and, in some cases, myopia control treatments are the primary options.

5. How often should my child get an eye check-up?

A child should have their eyes checked at 6 months, 3 years before starting school, and every 1-2 years thereafter.

6. Are contact lenses safe for children?

Yes, but they require proper hygiene and care. They are usually recommended for older children.

7. Can vision therapy help with refractive errors?

Vision therapy can aid eye coordination issues but does not correct refractive errors.

Conclusion

Recognising and addressing refractive errors early in children can significantly improve their quality of life. Regular eye exams, proper vision care, and timely refractive error treatment are key to ensuring clear vision and healthy development. 

At Maxivision Eye Hospitals, our expert ophthalmologists provide advanced diagnostic and treatment solutions for paediatric eye health, helping children see the world with clarity and confidence.

For expert eye care, schedule an appointment with Maxivision Eye Hospitals today!