Why does a child need glasses?

Children may need glasses for several reasons. Because a child’s visual system is growing and developing – especially during the first 5-6 years of life – glasses can play an important role in ensuring normal development of the visual system. It can be very challenging to recognize when a child needs glasses because they do not usually complain of blurry vision: when a child is born with blurred or weak vision in one eye they do not know that there is anything wrong. The main reasons a child may need glasses are:

  • To correct refractive error (nearsightedness, farsightedness, astigmatism), so that a child may function better in his/her environment.
  • To help straighten the eyes by correcting severe farsightedness when they are crossed or any refractive error when the eyes drift outward.
  • To help strengthen the vision of a weak eye (amblyopia or lazy eye). This may occur when there is a difference in prescription between the two eyes (anisometropia). For example, one eye may be normal, while the other eye may have a significant need for glasses caused by near-sightedness, farsightedness, or astigmatism.
  • To provide protection for one eye if the other eye has poor vision.

How can a child be tested for glasses, especially if they cannot read the eye chart?

A pediatric ophthalmologist can detect the need for glasses through a complete medical eye exam. Typically, the pupils are dilated in order to relax the focusing muscles, so that an accurate measurement can be obtained. By using a special instrument, called a retinoscope, doctors can measure an accurate prescription. Automated devices called photoscreeners and autorefractors can also help determine whether or not glasses are needed.

What are the different types of refractive errors that can affect children?

  • Myopia (near-sightedness): This is a condition where distance vision is blurred; most children with myopia can usually see well up close. This is present most often in school-age children, although occasionally younger children can be affected.
  • Hyperopia (far-sightedness): Most children are far-sighted early in life because their eyes are short. Typically children need no treatment for this because they are able to focus to see clearly at both distance and near. When there is an excessive amount of farsightedness, the focusing muscles may not be able to keep the vision clear. As a result of this, problems such as crossing of the eyes, blurred vision, amblyopia (where the vision in one eye does not develop normally), or discomfort may develop. In these cases children require glasses.
  • Astigmatism: Astigmatism is caused by a difference in the surface curvature of the eye. Instead of being shaped like a perfect sphere (like a basketball), the eye is shaped with a greater curve in one axis (like a football). If your child has a significant astigmatism, fine details may look blurred or distorted. If severe, glasses may be required.
  • Anisometropia: Some children may have a different prescription in each eye. This can create a condition called amblyopia, where the vision in one eye does not develop normally. Glasses (and sometimes patching or eye drops) are needed to ensure that each eye can see clearly.

How will I ever get my child to wear glasses?

That is a question most parents ask, especially when their child is an infant or toddler. The best answer is that most children who really need glasses will wear their glasses without a problem because they do make a difference in their vision.

Initially, some children may show some resistance to wearing their glasses, but it is necessary for parents to demonstrate a positive attitude. If the child does not cooperate, the doctor may prescribe eye drops in an attempt to help the child adjust to the glasses. Having an optician who is experienced in pediatric eye wear is also of great importance. The frame should be very comfortable with the eye centered in the middle of the lens. The frame should look like it fits the child now, not one that he/she will grow into in a year.

If you continue to struggle to get your child to wear their glasses full time, please contact our office. We may be able to prescribe you dilating eye drops to use on a daily basis for about 1-2 weeks. The drops will also make the pupils larger for a few days.

Why does my child need bifocals?

Children rarely need bifocals. Occasionally, children who have crossed eyes (esotropia) may need to have bifocals to help control the crossing. Additionally, some children who have difficulty focusing at near may require bifocals. Also, children who have had cataract surgery usually need bifocals or reading glasses.

Will wearing glasses make my child’s eyes worse or more dependent on them?

No. In fact, the opposite may be true. If a child does not wear the glasses prescribed the visual development may be stunted and your child may not have normal visual acuity as an adult.