Refractive Error: Types, Symptoms, and Treatment
Refractive error is one of the most common causes of blurry vision. It occurs when the shape of the eye prevents incoming light from focusing correctly on the retina—the light-sensitive tissue at the back of the eye.
Refractive errors can affect adults and children. While they can usually be corrected with glasses, contact lenses, or certain surgical procedures, early diagnosis is especially important in children. An untreated refractive error during childhood may interfere with normal visual development and cause amblyopia, commonly called “lazy eye.”
What Are the Different Types of Refractive Error?
The three primary types of refractive error are:
Myopia (Nearsightedness)
Myopia causes distant objects to appear blurry while close objects may remain clear. It occurs when light focuses in front of the retina instead of directly on it.
Children with myopia may:
- Sit close to the television
- Hold books or devices close to their face
- Squint when looking at distant objects
- Have difficulty seeing the board at school
- Complain of headaches or eyestrain
Hyperopia (Farsightedness)
Hyperopia occurs when light focuses behind the retina. Depending on its severity and the patient’s age, nearby objects may appear blurry. Children can sometimes compensate for mild hyperopia by using their eye-focusing muscles, which means the condition may not always be obvious.
Significant hyperopia may cause eyestrain, headaches, difficulty with close-up activities, or crossed eyes.
Astigmatism
Astigmatism is caused by an irregular curvature of the cornea or lens. Instead of focusing light at one point, the eye focuses it unevenly. This can make vision appear blurry or distorted at both near and far distances.
Astigmatism may occur along with myopia or hyperopia.
What Causes Refractive Errors?
Refractive errors are usually related to the shape or length of the eye, the curvature of the cornea, or the focusing ability of the natural lens. They often run in families and may change as the eyes grow or age.
Because children do not always recognize or report blurry vision, routine vision screening and comprehensive eye examinations are important.
Why Is Refractive Error More Serious in Children?
Clear vision is essential for normal development of the connection between the eyes and the brain. If one or both eyes consistently send an unclear image to the brain during childhood, the visual system may not develop properly.
This can lead to amblyopia, a reduction in vision that cannot always be corrected by glasses alone if treatment is delayed. Children may not complain about blurry vision, particularly when only one eye is affected, because the stronger eye may compensate for the weaker one. Early diagnosis and treatment provide the best opportunity for healthy visual development. AAPOS notes that untreated childhood refractive errors can cause permanent vision problems.
Signs That Your Child May Have a Vision Problem
Parents and caregivers should watch for:
- Frequent squinting
- Sitting unusually close to screens
- Holding reading materials close to the face
- Covering or closing one eye
- Tilting the head to see
- Frequent eye rubbing
- Headaches or eyestrain
- Difficulty reading or concentrating
- Poor school performance
- Eyes that cross or drift
- A failed vision screening
Some children with refractive error have no noticeable symptoms. A vision screening helps identify children who may need further testing, but it does not replace a comprehensive eye examination.
How Is Refractive Error Diagnosed?
An ophthalmologist performs an eye examination to assess visual acuity, eye alignment, focusing ability, and overall eye health.
For children, dilating eye drops may be used to relax the eye’s focusing muscles and obtain an accurate measurement of the refractive error. This is especially helpful because young eyes can temporarily compensate for certain focusing problems.
How Are Refractive Errors Treated?
Treatment depends on the type and severity of the refractive error, the patient’s age, and individual visual needs.
Common options include:
- Prescription eyeglasses
- Contact lenses
- Refractive surgery for eligible adults
- Treatment for associated amblyopia or eye misalignment
Eyeglasses are typically the first treatment for children. If amblyopia has developed, additional treatment such as patching the stronger eye or using prescribed eye drops may be recommended.
Schedule a Pediatric Eye Examination
Any child who fails a vision screening or shows signs of difficulty seeing should be evaluated promptly by a pediatric ophthalmologist. Detecting and correcting refractive error early can support healthy visual development and help prevent permanent vision impairment.
Contact Meadows Eye Physicians & Surgeons at (702) 358-0472 to schedule a comprehensive pediatric eye examination.