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Refractive Disorders in Children

(Refractive Errors)

By Christopher M. Fecarotta, MD, Attending Physician, Phoenix Children’s Hospital ; Wendy W. Huang, MD, PhD, Attending Physician, Phoenix Children’s Hospital

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(See also Refractive Disorders.)

In refractive disorders, the eye is not able to properly focus images on the retina, causing blurred vision.

  • Refractive disorders result in blurring of vision.

  • Children may be unable to make their vision problems known.

  • The diagnosis is based on the results of screening and vision testing.

  • These disorders can be treated with eyeglasses or contact lenses.

Refractive disorders, such as nearsightedness (inability to see distant objects clearly), farsightedness (inability to see close objects clearly), and astigmatism (an irregular curvature of the focusing surfaces of the eye), result in blurring of vision. Blurring occurs because the eye cannot focus images precisely on the retina. If uncorrected, a permanent decrease in vision (amblyopia) may develop.

Children are often not able to make their vision problems known or do not have symptoms. Sometimes a teacher or school nurse is the first to detect a vision problem.

All children should be screened for refractive errors and other eye problems. Children as young as 3 or 4 years old can view charts with pictures, figures, or letters used to test vision. Vision is tested in each eye separately to detect loss of vision that affects only one eye. The eye not being tested is covered.

Eye doctors, either ophthalmologists (medical doctors who specialize in the evaluation and treatment of all types of eye disorders) or optometrists, diagnose refractive errors by doing an eye examination and measuring the refractive error.

Treatment

  • Eyeglasses or contact lenses

In young children, refractive errors are generally treated with eyeglasses. In older, more responsible children, refractive errors can be corrected with contact lenses. However, inadequate care and cleaning of contact lenses can lead to eye infections.

Most pediatric ophthalmologists do not recommend doing laser treatments (such as LASIK) for children with refractive errors.

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