Astigmatism and nearsightedness in 6 year old

[MalSen]

Hi Doctor,
We took our son to regular ey check in last July when he was 5 years old. The prescription was as follows:
Od  -2.00  -1.75  005
OS  -2.00 -1.75 167
Doctor asked him to wear glasses. But as we noticed he never did not want glasses to see. School teachers were surprised that he needed glasses as he was doing well with out them. So we decided not give him glasses. After a year, August 2010, we checked his eyes again with a different doctor. The prescription is as follows:

OD -2.25  -1.00   0.20
OS  -2.50  -1.25  165

This doctor told us if we dont let him wear glasses his eye sight may be damaged and 20/20 vision is not possible with even glasses. My son still does not complain about any vision problems, headaches etc.
As we can see from his prescriptions, his astigmatism has reduced too. What should we do? Please advise us. We dont want his eye sight to get worse, Thats why we did not let him wear glasses. He really does not needs them as we can see.

I really appreciate your comments, suggestions in this matter.
Thank you very much

Mal  

[Chaydumon]

My daughter is only six years old and her vision now is -3.00 for the right eye and -2.00 for the left eye.i am worried that it will progress on the next coming years. Is there any prevention? For now, she will wear an eyeglass. But what if her vision has gone up to -9.00 and she cannot wear an eyeglass anymore because it's too thick already. And she also cannot wear a contact lens because she still too young. I am so worried, please help me on what to do.

[RobS4321]

Dear Dr John C Hagen,

My son's (6 yr old, going to be 7 yr old soon) last year (2013) eye Rx read like this:

OD (Right Eye) - SPHERICAL 0, CYLINDRICAL 2.50, AXIS 180
OS (Left Eye) - SPHERICAL 0, CYLINDRICAL 3.0, AXIS 005

This year (2014 Aug), the new eye Rx read like this:

OD (Right Eye) - SPHERICAL -3.5, CYLINDRICAL 2.50, AXIS 090
OS (Left Eye) - SPHERICAL -3.5, CYLINDRICAL 3.25, AXIS 100

We are surprised at the sudden introduction of SPHERICAL power.  Should we go for a second review?

Thanks,
Rob S

[John C Hagan III, MD, FACS, FAAO]

There is no universal agreement as to how or if myopic can be prevented, or slowed.  All sorts of things have been tried including glasses, bifocals, atropine eye drops, OrthoK rigid contacts.  These can often be expensive, unavailable and ineffective.

One interesting finding is that children that play outdoors dailing have less myopia than kids that sit and watch TV for hours on end. Be sure he gets some outdoors exercise/play regularly.

Remember that astigmatism is not a disease just a aspheric cornea and the astimatism actually reduces the total amount of myopia (by that I mean the spherical equivalent  you can look up the formula to determine that)

JCH MD

[Anuvasai]

Dear Dr John C Hagen,

Thank you very much for your kind reply, I feel reassured after reading your message.
My son has 6/6 vision with his glasses. Right ( sph:-0.50 cyl: -3.50 axis 180 ) Left ( sph:-2.00 cyl: -2.50 axis 5 )
I have worn glasses since childhood myself and my daughter who is 11 also wears glasses ( sph : -3.50) we are both myopic.
My biggest concern was about my son developing a lazy eye, you have explained as long as his vision is good with his glasses he is not likely to develop a lazy eye. Is there anything I can do besides limiting his time on tv etc to improve his vision?
You don't know how grateful I am for the time you are taking to help us,
Best regards
Anuva Deegan

[John C Hagan III, MD, FACS, FAAO]

Your biggest concern is what your child's vision is with those glasses.  If the vision is "good"  20/20 or 6/6 (metric) then there is likely no problem and he will liekly need glasses or contacts all his life. When he's older he may  opt for refractive surgery which likely by then can completely correct all the astigmatism.

There is very little change between the old glasses and the new glasses. Even if you child develops myopia as he grows as long as glasses correct the vision to normal levels it is not a problem.  The problem with children and glasses is when the vision is NOT normal with them that is referred to as amblyopia and it is a problem.

If you have other children they are at high risk for same condition so be sure all are checked by an ophthalmologist. Same for nieces, nephews and down the road grandchildren.

JCH MD

[Anuvasai]

My son has been wearing glasses for the past 1 year. His first prescription was Right :  sph: 0 cyl:-3.75 ax:180    Left: sph: -0.50 cyl:-2.50 axis 180
His latest eye check up revealed he has developed myopia too.
Now his latest prescription is :
Right sph : -0.50 cyl:- 3.50 axis 180     Left : sph: -2.00 cyl : -2.50 axis 5

My son is only 7 years old. Do i have anything to worry about his eye health. he wears glasses for all waking hours.
Any help will be greatly appreciated. May God bless,
Anuva

[John C Hagan III, MD, FACS, FAAO]

1. Yes it will make his vision worse because his distance vision will be bad. 2 Why would you want your child to play sports, go to school or play with such bad distance vision?

Will it make him more myopic if he doesn't wear them no, but that's not the point.

JCH MD

[Ken6765]

Thanks but what if he doesn't wear any glasses, would this make his vision worse?

[John C Hagan III, MD, FACS, FAAO]

This is significant myopia and, assuming the eye exam was normal and his vision with these glasses is normal, yes he needs to wear them all the time, if he plays sports he needs sports prescription glasses. regular glasses should not be worn for basketball, football, soccer, etc.

He does not need surgery. He may get more nearsighted. When he's older he may want contacts, not now.  Still later when an adult with stable RX he may want lasik surgery, not now.

JCH MD

[Ken6765]

My 7 year old son just got a complete eye exam from an eye doctor after failing the eye test at school. His right eye prescription is -2.25  -0.50 and left eye -1.50 -0.25  My questions are: does he need to wear glasses all of the time or only at school when he needs to see the board and is there any method or surgery to correct this?
Thank you

[John C Hagan III, MD, FACS, FAAO]

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[brightz]

He needs glasses , better for him to have glasses as JCH MD has advised you , the other side of the coin is irreversible ( refractive amblyopia ) .

[John C Hagan III, MD, FACS, FAAO]

He needs to wear glasses all the time, without glasses his vision may not develop normal due to refractive amblyopia. There is not that big of difference between test 1 and test 2.

He can only see clear up close. His distance vision will not be anywhere near normal.

REPEAT: he needs glasses all his waking hours.

JCH MD