Refractive Disorders in Children

(Refractive Errors)

ByLeila M. Khazaeni, MD, Loma Linda University School of Medicine
Reviewed/Revised Mar 2024
VIEW PROFESSIONAL VERSION

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.

(See also Refractive Disorders in adults.)

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. Some children may squint and frown when reading and excessively blink or rub their eyes. Squinting and frowning may lead to headaches.

Sometimes a teacher or school nurse is the first to detect a vision problem.

Diagnosis of Refractive Disorders

  • Screening

  • Eye examinations

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 at the time is covered.

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

Treatment of Refractive Disorders

  • 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.

More Information

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  1. Children's Eye Foundation of AAPOS: Practical information about prevention, detection, research, and education to protect the vision of children

quizzes_lightbulb_red
Test your KnowledgeTake a Quiz!
Download the free MSD Manual App iOS ANDROID
Download the free MSD Manual App iOS ANDROID
Download the free MSD Manual App iOS ANDROID