visual acuity in young children – what is “normal”?

· by · in toddlers with glasses. ·

When people ask what Zoe’s vision is, they’re normally expecting to hear her visual acuity – usually given as 20/20 or the metric equivalent 6/6 – and then they want to know how she compares with other children.  I don’t actually know what her uncorrected acuity is, but I was curious about what you might expect a preschooler’s acuity to be.

The Snellen and the Tumbling Eye Charts, both used to measure visual acuity. Image from AllAboutVision.com. (http://www.allaboutvision.com/eye-test/)

The Snellen and the Tumbling Eye Charts, both used to measure visual acuity. Image from AllAboutVision.com. (http://www.allaboutvision.com/eye-test/)

Visual acuity is the measurement of how clearly we see at a specific distance, usually 20 feet or 6 meters, though that can vary.  It is generally tested in adults with the well-known Snellen eye chart (the one with the big E on top) and with a variety of charts for children.  The acuity is usually presented as two numbers that indicate how close a person will need to be to an eye chart to see the letters or symbols clearly, compared to what a person with “normal” vision would see.    Let’s say my uncorrected visual acuity is 20/200 – that’s 6/60 in metric – (which it is, more or less, in my right eye).  That means that I have to stand 20 feet – or 6 meters – away from the eye chart to read the big E.  A person with good vision, on the other hand, could see the E at the top of an eye chart from 200 feet – or 60 meters – away.

It’s worth keeping in mind that visual acuity is not the whole picture (so to speak) when it comes to measuring vision.  Visual acuity does not indicate how well the eyes work together, or peripheral vision, or even what the prescription needs to be to correct vision.

For adults, it’s pretty easy to look at the acuity numbers to see how good your vision is: if the first and second numbers are the same, 20/20 or 6/6, that means normal visual acuity.  If the second number is smaller than the first, you have better than normal acuity, and if it’s larger than the first your vision is poorer.  But for young children, it’s not quite as straight forward.  Because children’s vision hasn’t completely developed, a child can have “normal” vision that is worse than 20/20.

In 2003, the American Academy of Pediatrics adopted a policy on Eye Examination in Infants, Children, and Young Adults by Pediatricians.  According to those standards, pediatricians should refer any child under the age of 5 with a visual acuity of worse than 20/40 – that’s 6/12 in metric – to an eye doctor.  At age 6 and older, they should refer any child with acuity of 20/30 – 6/9 metric – or worse.

More recently, though, a study called the Multiethnic Pediatric Eye Disease Study looked at visual acuity norms in preschool children with the goal of gaining more accurate visual acuity norms for children.  The results were published in Optometry and Vision Science in June 2009 (abstract and full citation).  They measured the visual acuity of 1,722 children ages 30 to 72 months with no significant refractive errors – so kids that should have good vision.  From those measurements they determined the threshholds for visual acuity that would include 95% of the children tested.  That means that if the test were done by pediatricians and these guidelines were followed, you’d expect that 5% of children with no refractive error would be referred on to an eye doctor for a follow up.  You’d hope that all of the kids with visual problems would also be caught with the testing and also be referred on to an eye doctor.  That’s not necessarily the case, the researchers note that children who have “normal” visual acuity may still have visual problems, but that’s a topic for a different post.  The nice thing about this study is that it breaks out the age range in to more detail, understanding that vision is still developing significantly in children between the ages of 2 1/2 and 6.

So, according to this most recent study, normal visual acuity for preschoolers may be better defined as:

30 – 35 months:  20/63  (6/20) or better

36 – 47 months:  20/50  (6/15) or better

48 – 59 months:  20/40  (6/12) or better

60 – 72 months:   20/32 (6/10) or better

90 responses to “visual acuity in young children – what is “normal”?”

  1. The American Optometric Association wants to stamp our amblyopia/lazy eye in our lifetimes. That’s why they started a program called InfantSee. Don’t wait for your pediatrician to send you to an optometrist…do it now. Find an eye doctor who will assess your little one’s vision at no cost by going to http://www.infantsee.org today. For the latest in children’s vision research go to http://www.mainosmemos.blogspot.com

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    • Hello Sir,
      We found out my grandson was diagnosed with Coats Disease. Long story short, they took him to outpatient OR, took off some “yellow” stuff from the back of his retina, froze come capillaries and not sure what else. Today, he had his follow up visit and the doctor wrote a prescription for T-ball protective lenses, but I was perplexed because within that prescription, he wrote the following: ” 4 y/o legally blind right eye and 20/30 vision left eye. I highly recommend wearing to wear protective glasses during sport activities”…. I was shocked…I smiled and excused myself from the room and left my daughter and my grandson there and I regret that because I didn’t ask questions. it just hit me so hard to hear that news. Does this mean he can not see anything out of his right eye (meaning he sees black) and what does 20/30 mean. And will this affect him for the rest of his life… I’m sorry I’m bombarding you with questions, but i found this site as soon as I got home today. Please, I need help in determining what we’re dealing with so that I can be strong for him. Please and thank you,
      Anna Olivares

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  2. Thanks Dominick, I try to pass the infantsee information to all my moms groups and think it is a great program.

    I really haven’t stayed on-top of Elly’s visual acuity. In the beginning she was estimated at 20/ 1200 and in a -5.5 perscription. In the last year she has dropped to a -8 perscription. Does the visual acuity change… this is something I will try to remember and ask the vision specialist in the morning.

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  3. Elly’s prescription change means the little one became more nearsighted not less. The higher the number the “more” the refractive error amount. As you become more nearsighted usually your visual acuity reduceds until you are given a new pair of spectacles. Then you should see OK. You might want to have a VEP/Sweep VEP (Visually Evoked Potential) done to get a better handle on the visual acuity.

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  4. Hi there my 7 year old daughters VA is 3/19 (metres), everything that i see on the internet is is always referred to from 6 metres distance. Is there a way to convert her VA of 3/19 to the 6 metre distance? cheers Belinda

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  5. This is such wonderful info. I can’t believe Stella, at 28 months, has one eye at 20/20. I remember being told, before she had glasses, that her visual acuity was above average for her age. But after that, the left eye’s acuity started going down, but now it’s back up to 20/30. Like you said, visual acuity is just one piece of the puzzle. It’s all so confusing yet fascinating.

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  6. hi ann,

    My kid who is 5 1/2 years old has visual acuity of 6/9 or 20/30. From the above it looks like this should be acceptable below 6 years. Does that mean they dont require glasses?

    Thanks,
    Man

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  7. My son is almost 6 years old, and I was told by an optometrist that he is farsighted. Giving us a correction of +2 ou, for reading. But then the doctor mentioned that sometimes this is normal, so if my son doesn’t have any problems to leave it alone.
    I don’t know what do. Is it normal? should I get my son reading glasses?

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    • Farsightedness or hyperopia is a bit trickier than nearsightedness (myopia) and astigmatism. With farsightedness the vision system is never at rest. For instance when we look far away our focusing system should be resting….and then turned on as we look closer and closer. With farsightedness you have to continually focus for all distances all the time. What is “normal” for a child with farsightedness will vary with age and visual demands. For a child who is six years of age I would consider +2.00 right on the edge of where I might recommend glasses. Does the child have any other vision problems? Blurred vision, headaches, eye turns, etc? If not I might wait before prescribing glasses. The other thing to remember that our academic curriculum has shifted downward significantly…children are being taught to read and reading at much earlier ages. This is not necessarily a good thing…especially if the child has farsightedness….which can make reading very difficult. When in doubt….seek a second opinion. Beware that doctors will vary widely when it comes prescribing…especially for hyperopia…..and MDs do not tyically prescribe as often as ODs. For a doc who could give you a good second opinion, I would suggesting go to the College of Optometrists in Vision Development at http://www.covd.org and click on their Dr. Locator button in the upper right field. Hope this helped a bit.

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      • Thank you so much, Dr. Maino, that was a fantastically clear and helpful explanation. I feel like I’m always learning something when you post here!

        Sent from my iPhone

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      • Thank you so much, this really helped. You are basically said the same thing as the optometrist, you are my second opinion.
        My son doesn’t have any other problems such as, crossed eye, headaches, poor school performance; about the blurry vision I don’t think he would know any different. Anyways, he is in kindergarten, doing great in school and reading above grade level. So, I am just going to wait and see.
        Thank you again,
        Rossana

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  8. Hi my daughter has just turned 5 yrs old, I booked her for a routine eye test, my daughter has no complaints with near or far distance, how ever when optometrist did ret it showed her right eye was -4.50ds and le -3.00ds, on snellen chart she managed to read 6/9 with out refraction, with refraction le -1.50ds she read no better on chart but he was adiment that le prescription is -1.50ds with a +1.00ds blur le was 6/12+, in re with over refraction of -3.00ds she saw 6/10, again over refraction did not make her read any better. The optometrist has rebooked her for another day a morning test, to do the eye test again, and to refer her to the hospital, I am very concerned on what the outcome will be. concerned mum

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    • Your daughter has a fair amount of myopia (nearsightedness) that could cause amblyopia (lazy eye). The visual acuity without refraction seems much too good to be true unless your child was squinting….in any case, I might take the visual acuities with a large grain of salt. Did the doc use dilating/anti-focusing drops and then re-check not only the eye health but also the amount of nearsightedness present? Bringing your little one back for a re-check is a good idea….don’t know why she would need a referral to a hospital at this point. If she has amblyopia…once the prescription is verified the best thing to do (as shown by research clinical trials) is to put a pair of glasses on her for full time wear and then to follow her closely. If the glasses do not get her to the visual acuity we would like, then more aggressive therapy is needed (optometric vision therapy…check out http://www.covd.org). Keep me posted on her progress.

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  9. my daughter is 4yrs old. her vision is 6/6 in rt eye and 6/9 in left. auto raf gave the cylindrical power of -2.5 in left eye and -.75 in rt eye. shud i go for dialatation test.her binocular vision is 6/6.

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  10. Hi all, I yesterday found that my 19 months old son vihan needs glasses to wear +6.5 for left and +4.5 for right eye. He actuall had started showing squinting eyes so we took him to paediatric opthamologist. Dr prescribed him for glasses and to conduct ERG for some suspected spots in his eye. I don’t know what to do dr says right now it’s difficult to say about vision, n we need to see a doc every 3 months or so? R we late ? Will the vision deteriorate further ? Pls suggest”……

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  11. My just-turned 10-year-old son’s eyes were tested and found to be 20/30 in both eyes. The doctor recommended glasses, but my husband is not sure we should do that yet, fearing that wearing the glasses will cause a reliance on them and worsening of our son’s eyesight sooner. My son has no complaints about his vision, no headaches, squinting, etc. He says he can see the board at school with no problems, etc.

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    • Glasses DO NOT cause dependence….just like shoes do not make your feet dependent upon them… Both shoes and glasses make it easier to do what needs to be done… See or walk. I want all my patients to see the best they can. 20/30 is not bad vision….but if he can see 20/20 wouldn’t you want him to? Since I have not examined you child, I do not know what else is involved here…but in general…trust your doc!

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  13. My son is 11 and has a visual acuity of 6/12 (we are in the UK) with his glasses on. I have been told that there is nothing they can do for him now because of his age. He was never patched as a child, my other son was sent to Great Ormond Street Hospital as he had both ptosis and a lazy eye. The Ptosis was operated on when he was 3 and his lazy eye treated successfully with atropine eye drops twice a week. Some advise on what I can do, should I ask our optometrist to refer my elder son to a hosipital, I am not prepared to give up on my soe only see half of what I see and if things go as planned in the UK he may never be able to drive.

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  14. Hi, my daughter is 5 1/2 years old and on a routine checkup in school, we were told that her vision acuity was 6/9. Pl. advise should i take her to an eye specialist or is it normal for a kid of her age ?

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  15. Pingback: Myth busting with Kids’ Eyes Online « little four eyes·

  16. Hi! Dr. I just would like to know if it is normal for my 2 turning 3 years old son to have -300 cylinder on both eyes.. I have checked him only to AR finding only… Is there anything I have to be bother or eyes will still develop in time? thanks and more power- D.Bel

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  17. My 3 and a half year old failed his pediatrician’s eye exam and we were referred to an optometrist. Here we were told his left eye needed a prescription of +2.50 and the right eye was needed no prescription. His final prescription given was +1.50 in both the left and right eye which we were told was for balance? I am wondering if this is common or if I should seek a second opinion.

    Thank you for your help.

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    • Jamie, I would get a second opinion. I’ve never heard of putting a higher than needed prescription in for “balance”, though of course i am not an eye doctor and don’t know all the details of your son’s vision. If you do get a second opinion, I’d be really interested to hear how it goes!

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  18. Hi there,
    I just have a vision test for my 9 year old son and was shocked with the result as we have never noticed any thing unusual with his vision and we don’t have a family history of problems in vision at all.

    The result was:

    Dist: OD Sphere. -1.75. OD Cylinder: -0.75 OD Axis: 180

    Dist: OS Sphere: -1.25. OS Cylinder: – 0.50 OS Axis: 030

    I have some queries and would highly appreciate your feedback:

    1- what does this mean in 6/6 and 20/20 ?

    2- how bad is his vision according to this result?

    3- what are the possibilities to have errors in this result ? I am asking this for a couple of reasons. My son was tired and exhausted when he had this vision test. He also was confused of what the optician was expecting from him when he was reading the chart and was reading the numbers that are at the beginning of each line and therefore couldn’t read most of the lines. When I realized this, I asked him to forget about the numbers and to read the letters only. The optician did NOT redo the chart test for him after realizing my kid was confused.

    4- In case this result was accurate, what are the possibilities to have his vision back to normal and what should I do to strengthen his eyesight ?

    Thanks in advance and best regards

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  19. My son is seven years old , Not complains at School however he gets lost whenever reading book , eyer redness while watching tv for more than 30 min . his vision was tested and recived 20/25 and 20/20 should take him to see and optamologist myself ?

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  21. My 4 years old just had a physical and her vision was 20/40 ou. Is that normal? What does it mean. Should I be concern.

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  23. My daughter is 34 months (was a preemie) and we just had her eyes checked. I was told she was at a +4 in each eye, equaling 20/40, with a astigmatism. My husband and I are wondering if it is too soon to put her in glasses? I know that most kids around 3 are 20/30 and really she isn’t that far off. So should we just recheck in 3-6 months. Or go with glasses. Or are there types of eye therapy we can be doing? I don’t want to hinder her learning, but also don’t want to put her in glasses if we don’t need to yet.

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  24. My child is 5 years old and has been wearing glasses with patching for a year and a half to resolve amblyopia. Her vision is now equal in both eyes and her prescription is +2.00. Does anyone know if she will continue to have to wear glasses? Her eye sight is now in the “normal” range of farsightedness for her age.

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    • Do her eyes cross at all without her glasses? I know that some farsighted kids certainly can outgrow their need for glasses, especially if they have a relatively low prescription. Have you asked her eye doctor about trying to step down her prescription? Zoe’s eye doctor has said that she would be willing to try stepping back Zoe’s prescription so long as her eyes aren’t crossing, unfortunately, that hasn’t been the case yet.

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  25. My 6 year old daughter was just seen as a result of a failed eye exam at the doctors office. She has Hyperopia with astigmatism. The Cyclopegic Refration was:
    R: Sphere +3.00 Cylinder +1.75 Axis 092
    L: Sphere +3.00 Cylinder +1.25 Axis 093

    Her final RX for glasses was:
    R: Sphere +2.00 Cylinder +1.50 Axis 092
    L: Sphere +2.00 Cylinder +1.00 Axis 093

    She has been given glasses to reduce permanently reduce vision to her right eye. She has never complained about vision issues.

    How bad is her vision per this information? Is there a possiblity her vision will strenghten, as I know it can get better with farsightedness, to the point see will not require glasses or will she always require them due to the astigmatism?

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    • Hi Kathy, it looks like she has moderate farsightedness and astigmatism, certainly enough that she might experience eye strain, especially as she starts doing more close-up work at school. Some children will outgrow their farsightedness, though it’s not a sure thing. As for astigmatism, that can change through childhood. There’s more information about understanding glasses prescriptions here.

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  26. my son has had a lazy eye intermittently since he was 3. he is now 4 and I am waiting for my appointment at Royal childrens hospital (Melbourne, Australia) to see a specialist at the eye clinic. his vision was 6/6 rt and lt (Sheridan gardiner test). Cycloplegic refraction was apporx +2.00/-0.50×90 rt and lt. I have tried to stress my concerns for over a yr and it has finally been picked up. what should I expect from here.? I hate waiting and I would like to know what to prepare for. thankyou.

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    • Kylie,
      I just came to this site. I read your post. Did it ever get resolved as to what what happening with your son’s eye issues? I ask because my 4 y/o grandson was also complaining of his eye like your son and he kept on saying something is scratching etc… long story short, he was Diagnosed with Coats Disease. I would recommend you read up on that. Also, we noticed a glow in his eye every single time we took a picture of him with a flash. his eye would glow yellow..

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  27. can I also add.. he has been “seeing” bugs every night for the last 6mths. He wakes up seeing them and is frightened to sleep. atleast twice a night. Do you think this could be floaters or something to do with his vision? I have tried to find answers but cant seem to find them. I know it has something to do with his vision. (mum instinct) but was wondering if you have heard others express the same problem/or similar?

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    • That really sounds like floaters. Does he say if they are dark or if they’re flashes of light? Usually, floaters are harmless, but they can be a sign of serious vision issues especially if they are accompanied by flashes of light or started suddenly.

      And good for you for pushing to get your son’s vision checked, I’m so frustrated that your concerns have been ignored for so long. If your son is occasionally crossing his eyes, then it’s very likely that he will be prescribed glasses for farsightedness, even though his prescription is not terribly strong. It’s possible that he’s developed some amblyopia (lazy eye), though a lot of doctors prefer to treat with glasses first since some cases of amblyopia resolve simply by correcting with vision. Otherwise, the treatment for amblyopia is typically patching the strong eye.

      Good luck!

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      • he says the bugs are in my eyes. its traumatising for him and me. He said he sees flashes of light but his more worried about the bugs. I took him to the eye doctor 12mths ago and because he was so young he wouldn’t sit still, the doctor said “bring him back in 12mhs when his older”. (Im not happy about this at all).. I took him to a pedatrian when he was 3 because he started complaining of pain and his eye “wobbling”. because of his age he was put to sleep and had a MRI on his brain. results came back normal and that was the end of that??? He dosnt complain of pain anymore (probably due to the fact that he has compisated with the strong eye). He rubs his eyes a lot, squints and sometimes closes one eye (lazy eye) to focus. The bugs at night worry me ALOT because of all this other stuff going on with his eyes. But im dismissed when have tried to get to the bottom of it. Frustrating to say the least.

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  28. I can’t seem to find where to ask questions so I’m trying here.

    My 5 year old had an in school screening the other day. Her results were 20/63 bilaterally. My husband and I were both prescribed glasses for distance and astigmatism by the age of 7. We are seeing the Pediatric Opthamologist Tuesday. I’m trying to figure out if the results warrant glasses or not. She is asking tons of questions and I’m not sure which direction to steer her in. I realize each child is different, but I’m wondering if the norm would be glasses or not. I appreciate any insight. Thanks
    Rose

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    • Hi Rose! With that acuity, I think glasses would be warranted. Especially as she’s school-age now, and poor acuity is closely related to difficulties in school. I’m glad that you have an appointment coming up. Please let me know how it goes.

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      • So, we saw the Peds Opho. Results, no corrective lenses. yet… The results of her examination were – astigmatism in both eyes. .75 and 1.25. He said one eye was nearsighted and 1 was farsighted and her v/a was 20/63. This docs opinion was to wait it out and told me to bring her back in a year. He feels her eyes will worsen and she will become bilaterally near or farsighted so wait for that and then correct it. (My husband and I both started with glasses by age 7.) When I questioned his recommendation he explained that with her age and academic requirements (no looking at black or smart boards, no lengthy reading etc.) correction was not necessary. However, now that I am aware of her vision deficit I see her leaning very closely to paper to color and write, her heads right in the book (so I can’t read the words because her head is in my way) when reading stories and she’s inches away from the page when working on eye spy or search and find. Before learning of her v/a I chalked this up to an eager 5 year old but now I’m thinking otherwise. I am thinking a second opinion is a good idea. Any thoughts?

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        • I would absolutely support getting a second opinion, especially if you’re now noticing what looks like her struggling to see.

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  29. Hi, Mywson is 4 yr old, he was prescribes by doctor for specs and said following thing

    Sphere: OD +, OS +0.25
    Cylender: OD +1.00
    Axis: 10*
    what does it mean? and any possibility specs could be removed

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  30. My 7 year old daughter has got cylindrical power of (worried & concerned)
    Right eye : -2 cylindrical and spherical +.50, axis180, vision 6/9
    Left eye : -2.50 cyl and +.50 sph, axis 180, vision 6/6

    Few questions, plz help
    1. What could be the cause??
    2. How bad is it?
    3. Would she have to wear glasses throughout her life?
    4. Any corrective method? Eye exercises/ diet etc
    5. What can I do as a mother to help my kid ??

    Please help clarify my doubts

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    • Hi Upasna,
      This means that your daughter has astigmatism, which sounds intimidating, but really just means that her eye is not perfectly round. In fact, everyone has astigmatism to some degree, your daughter’s is enough that she would definitely benefit from wearing glasses so that she can see clearly.

      Astigmatism can shift through childhood, but doesn’t tend to progressively get stronger or weaker. It’s likely that she will need glasses or contacts throughout her life.

      Eye exercises and diet won’t help change the shape of her eyes. The best thing you can do is get her glasses so she’s seeing clearly and talk with her about the benefits of seeing well, and help her pick out glasses that she loves! My daughter is 8, she wears glasses for a similar level of astigmatism (as well as farsightedness). Her glasses don’t hold her back from anything, though they certainly help her in school.

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  31. My 6yrs old has a power in her right eye +0.75 , -1.25 ,15 and her left eye has +0.50, -1, 9. How to cure. How serious it is?

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  32. DrMaino

    My son is 6 years old. We went for his eye check that reslted in -1.5 for both eyes with a bit of cylyndrical difference.. The thing is that he has never complianed about his vision. headache, blur vision or not able to read. what do u suggest

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    • Hi Ammad,
      I have always recommended a second opinion if you’re not comfortable with the doctor or the advice you’ve been given. However, remember that many kids will not complain about vision problems because they don’t realize that they could be seeing better.

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  33. My son had a eye test done at school, they said his left eye was 20/200. What dose this mean? And his right eye was 20/30

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    • Hi Mike,
      20/200 means that with his left eye, what he can see clearly at 20 feet, a person with “normal” vision could see clearly from 200 feet away. With that acuity, the top line of an eye chart is quite blurry. Given that his right eye has much better acuity, it is likely that his brain is largely using his right eye and ignoring the input from his left eye. The problem with that is that it reduces stereovision and 3d perception, and it can lead to amblyopia (lazy eye) which can lead to loss of vision in the left eye if left untreated.

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  34. Hello my son.is 6.5 year old and he has got the right eye vision 6/24. AND LEFT EYE VISION 6/18. KINDLY SUGGEST HE REQUIRED ANY TREATMEnt

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    • Hi Sudheendra,
      It sounds like you son has different visual acuities in each eye. If you haven’t seen an eye doctor yet, I would absolutely recommend it. Often glasses are the first line of treatment, but some eye doctors will want to do patching as well.

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      • Hi my 5.5 year old son is diagnosed with 6/19 and 6/24. Is it normal to for kids to have this eye power? Does it improve with age?
        What is the equivatent of these powers in +/_ diaopters (e.g.+/- 1, 2, 3, 4, 5,6, etc)
        Kindly help.
        Regards

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  35. hello doctor,
    i just want to know, my son 7 yrs old is having a high astigmatism according to his age his astigmatism is higher than normal average at his age. now he is wearing eyeglasses. is is fine if he will use eye glasses at school and at home he will not used?

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    • Hi Judith, a high astigmatism will make everything blurry at all distances. You should check with his eye doctor to find out what he or she recommends for your son’s specific case, but often in those cases, they’ll recommend full time glasses wearing.

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  36. Hi how bad is following prescription ..what precautions I should take …
    RE
    Sph 1.75 cyl -3.50 axis 5
    LE
    Sph 0. 75 cyl -1.59 axis 10
    Pl help

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  37. Hi, I just got back from optometrist with one of my 4yr old twin girls. Dr gave her prescription of R +4.00, -0.50 x 5 and L +4.25, -0.50 x 180
    I just need to know what this means. Am I correct in saying she is far sighted? Does any of this also suggest astigmatism? How bad is it? What are the chances that the identical sister will also need glasses? With everything we have seen the one following behind…development wise even little ailments.

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    • Hi Maud, the first number indicates farsightedness (the + tells you that). The second number is the amount of astigmatism, which is pretty mild.

      Since vision issues can be genetic, it would absolutely make sense for her sister to have an eye exam as well.

      Best of luck!

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      • Thank you Ann, we saw the Dr today and it turns out Twin B is also farsighted although not too high to warrant glasses. We will monitor yearly or unless we see symptoms of her struggling. Dr did however point out that the vision in the eyes is quite different we might at the worst scenario go for patches, but doubts it would get that far.

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  38. Thanks for this info. According to the chart, my 3-yo daughter’s VA of 20/30 appears to be in the normal range, however the reason I took her to the ophthalmologist was that she crosses her left eye when looking at something in close range.
    We just got back from the appointment with a prescription for glasses,I can’t really make out what it says, though. It seems to say “0? + 2.50, 05 + 3.00”.
    Would wearing glasses potentially correct her vision in such a way that she wouldn’t need glasses for ever, or is there a chance that her eyes would just get used to the glasses and never improve?
    May patching perhaps be a better option? The ophthalmologist said that me having been patching her “good” eye (meaning the one she doesn’t cross) may have kept vision equal in both eyes, which sounded good to me.
    I’m confused as nobody in my family has any vision issues and this is all completely new to me.
    Any hints and thoughts?

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    • Hi Aelin, that’s a really good question. My guess with the prescription is that is says: OD +2.50 and OS +3.00. “OD” is the abbreviation for right eye, “OS” refers to the left eye (it’s the latin abbreviation). The numbers after the OD and OS are the prescription and they indicate a mild to moderate farsightedness.

      Kids are generally naturally farsighted, but when they are too farsighted, they can use their accommodative reflex to focus through the farsightedness. Unfortunately, that strains their eyes and often causes them to cross. When their eyes cross, that can lead to the brain suppressing vision from one eye to keep from seeing double. Treating kids for crossed eyes is very important to their visual development, and glasses are one of the common treatments if the crossing is due to farsightedness.

      Wearing the glasses should keep your daughter’s eyes from crossing and help her to develop vision using both eyes (binocular vision). Patching may have kept her from favoring one eye over the other, which is awesome, but it will actually prevent her brain from learning to use her eyes together. She needs the glasses to help her brain learn to see clearly without straining through the farsightedness. Some kids will eventually outgrow their need for glasses if they are farsighted. Some kids will not. I could not say if your daughter will be one of them.

      I hope that helps!

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  39. My 4 year old son got diagnosed with cylindrical power of 2.5 in both his eyes whereas no spherical power was present… He is recommended to wear glasses immediately.. What I wanted to know is how is it possible to have such a high cylindrical power with no spherical power? Will this condition improve with age? Does he have to wear glasses lifelong?

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    • Hi Debarati, the cylindrical power means that your son’s eyes are not perfectly round, so that along one axis, your son’s eyes need +2.50 correction, and along the other axis, they need no correction.

      Optometrists and ophthalmologists generally write the prescription differently (ophthalmolgists write the CYL with a + number, optometrists write it with a – number). That prescription could be written as SPH +2.50 CYL -2.50 (and the axis changed by 90 degrees) — and it would mean the same thing and result in the same lenses being made by an optical lab.

      I used the astigmatism converter here to do that: https://www.aclens.com/PositiveCYLConverter.asp

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  40. Hi yesterday our ophthalmologist diagnosed that My 4.5 yr kid have eye sight as Right Eye = 6/24 and Left Eye= 6/9 . I worried too much can you advice is any option to increase the eye sight by excersise

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  41. Hi, my 4 year old daughter was sent home a letter that referred her to see an eye doctor . The numbers on her sheet are as followed:
    R 8 S+2.1 C+ 0.2
    L 7 *S+4.8 C+ 0.6
    We are going to make an appointment ASAP but I am extremely worried 😦
    Can someone please help me understand what this means?

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    • Hi Christine. In guessing this was from an autorefractor used in a vision screening. They can indicate when there is a vision problem that should be checked out, but you shouldn’t worry too much about the exact numbers given, an eye exam will get a much better prescription.

      The numbers before the S are the spherical error – a positive number indicates farsightedness and negative indicates nearsightedness. The numbers before the C would then tell you the cylindrical error, or how much astigmatism is present. From looking at this, she has strong farsightedness and a strong astigmatism. The biggest issue might be the difference between the two eyes, which puts her at risk for lazy eye of her vision is t treated (most likely with glasses)

      So the good news is that you’ve caught this and you’re getting her in to see a doctor, and the prescription numbers here (though they might change with an actual exam) are prescriptions that are definitely in the range of correctable with glasses. Please let us know how the appointment goes and best of luck!

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      • Thank you Ann! We have an appointment set for 3/4. Will definitely give an update after we see the pediatric ophthalmologist. This was so helpful for preparing as to what to expect and getting some clarity not just a note sent home with numbers on it to see an eye doctor!

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  42. my son has lazy eye he is 15 now and doctors says there is no cure for him meaning he is half blind for the rest of his life. I was never informed by his pediatrician that he had sight problems neither i noticed anything abnormal. I took him to see an eye doctor when he was 8 because the school send me a letter and they put him in the patches but i guess it was too late. can someone comment on this. was this my fault? or wasn’t his pediatrician supposed to noticed this? please coment

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  43. Hello, my son had about 20/40 vision when he was 8, probably 20/50 when he was 9, and 20/70 when he was 10, which was just about 6 months ago. Doctor said his vision would keep getting worse whether or not he wore glasses (he is near sighted), and that using glasses would not heal or hurt his eye development. He was very upset at the thought of wearing glasses so we decided to wait a little longer to put him in glasses since it seemed there was no harm in doing so. Took him in for an eye exam this week and was so discouraged, he is now at 20/200 in both eyes! Prescription is -2.25 in one eye and -2.5 in the other. any idea why his eye sight would deteriorate so much within just 6 months? Nothing major has changed except that we moved to a new house. He was still sad at having to use glasses but we have filled the prescription and he is happy now that he sees how much better he can see with glasses. Should we have made him wear glasses earlier on even though he didn’t want to? Could that have slowed down the progression of his myopia? Have you heard of many other kids his age with such strong prescriptions or with such big changes in vision over the course of say 6 months? Thank you very much.

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  44. Hello,

    Came across this site and felt it was very useful and really appreciate the time you are taking to answer the queries.

    My son is 3.4 years old and went for a general eye checkup and doctor told that he has -1d for left eye and right eye. He actually did not pay attention in reading the eye chart as he is very small. Doctor has suggested for glasses for him.

    Does he nearly need to wear glasses or the vision will improve for him. Please respond.

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  45. Hi,

    My Son is 4.5 yrs Old and when we had his eye check up. the below numbers came:

    Right : S +0.5 Cyl -1.0 with Axis 10
    Left : S +0.75 Cyl -2.0 with Axis 170

    Can you please suggest if this cyl power would be corrected with age as he is still growing. Do we need to start glasses and continue through out. Can you please suggest.

    Like

    • Hi Vikram,
      I would go by the recommendation of his eye doctor. Astigmatism can shift through childhood, sometimes getting stronger, sometimes weaker. The biggest concern, I think with his prescription as you list it here is that one eye has a considerably stronger astigmatism, which puts him at a higher risk for developing amblyopia in which the brain suppresses the vision from the eye that is receiving the blurrier input.

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  46. I am a 25 year old who works as a navigation officer, I recently had an eye test as required by my employer the general practitioner found out that my eye sight has deteriorated in da past year from left eye 6/5 to 6/6 and right eye from 6/5 to 6/9 he seemed quite concerned abt my right eye and instructed I see an optometrist. Does the determination mean I will have to wear glasses? What can I do to prevent the eye sight from deteriorating even more. my employers demand that their employees wear glasses when their vision is 6/12. Please advice

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  47. I recently brought my 7 month old to an infantSEE appointment. They dilated her eyes but did little else. No toys, visual stimulation, etc.. He said he could see the back of right eye but not left. Her vision is +3.50 left, +3.00rt. Her eyes seem to cross a little bit and when she puts toys in her mouth she often hits her head and drags them to her mouth. They didn’t ask any family history or anything. Should I try to get a more thorough exam?

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  50. Hi Dr. I have 5 year old very healthy twins, they were born at 35 weeks, but needed no NICU time and have never had any health problems (thank God) my question is : they got a 20/40 on both eyes at school on the snellen eye chart test. i than took them to their pediatrician and they redid it and they both got the same thing. at the pediatricians office they played and acted silly so I dont know how accurate that was. I am going to take them to a pediatric optometrist, just havent dont it yet. My question is is this normal for children that age, and does being a preemie have anything to do with it. Will they need glasses even though its very very minor. never have we noticed anything. when they read they read just fine at a normal distance.
    thank you so much for your answer.

    Like

    • Hi Miriam,
      I am not a doctor, but seeing only 20/40 is a reason to refer for a full vision exam. A pediatric optometrist will be able to do a full exam which will be able to tell if your twins really do have a vision problem that needs correcting. Children who were born premature do have a higher risk of developing vision issues later on. As your twins are not at the age where they’ll be in school more with more visual demands, it is important to correct vision issues. Many kids are able to focus at a reading distance, but it requires extra effort to do the focusing, leading them to become fatigued more quickly and making reading more difficult than it needs to be. Other kids struggle to see the board, which again can impact learning. Again, the eye doctor will be able to assess their vision and recommend whether something like glasses is needed.

      Best of luck!

      Like

  51. Hello @Dominick Maino, OD, MEd, FAAO, FCOVD-A

    My son is 4.5 years old. His vision is 6/18 in both eyes. Does he need to wear glasses or can wait for sometime until he has no problem in seeing? His power is -1 and -1.25 . Will it increase with his age? Please let me know your advice. Thanks in advance

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  52. Hi,

    Need your help in the eye prescription for my 4.8 years old daughter. Doctor has diagnosed as Myopic Astigmatism.
    Right Eye: -3.0 Cylindrical 180 Axis,
    Left Eye: -3.50 180 Axis.

    Sorry for the more number of questions.. tensed and worried 😦
    1) Could you please let us know if this is too high astigmatism which could lead to lazy eye?
    2) is this simple or compound astigmatism. Is there any ways to avoid the progression of this?
    3) Should the kid wear the glasses all the time and should we go with -3.5 glasses or lesser
    4) any natural method to avoid the progression like sunning, eye exercise etc

    Like

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