Astigmatism is a common vision condition affecting people of all ages, including children. It involves an imperfection in the curvature of the eye’s cornea or lens, which affects how light enters the eye. Normally, the cornea and lens are smoothly curved, allowing light to focus sharply on the retina. With astigmatism, this curvature is uneven, causing light to bend improperly and resulting in blurred or distorted vision at various distances. Early detection is important for proper visual development in children.
What is Astigmatism in Children?
Astigmatism in children arises when the cornea or the eye’s internal lens has an irregular, egg-like shape instead of a perfectly round one. This irregular shape means light entering the eye bends unevenly, preventing it from focusing precisely onto a single point on the retina, the light-sensitive tissue at the back of the eye. Instead, light focuses at multiple points, leading to blurred or distorted images.
Astigmatism is often present at birth and frequently has a hereditary component, meaning it can be passed down through families. While the exact cause for the irregular curvature is not always known, it is considered an irregularity within the eye’s structure. Children with astigmatism may exhibit various signs and symptoms, although very young children might not complain directly because they do not know what clear vision should look like. Parents might notice their child squinting frequently, rubbing their eyes, or complaining of headaches, especially after activities requiring visual concentration. Difficulty reading, eye strain, tilting the head to see better, or sitting unusually close to digital screens or books can also be indicators.
Can Astigmatism Improve with Age?
Many parents wonder if a child can “grow out of” astigmatism. Some mild cases, particularly in very young infants (between 6 to 12 months of age), may resolve or decrease as their eyes develop. Research indicates that while about 23% of infants in this age group have astigmatism, this percentage drops to around 9% by school age (5 to 6 years old). This suggests some spontaneous improvement can occur in early childhood.
However, it is not common for moderate to severe astigmatism to disappear entirely as a child gets older. While population prevalence might remain stable, individual children may experience changes. Astigmatism can decrease, increase, or stay the same as a child grows. Significant changes in astigmatism are generally less common after early childhood, and if left untreated, it can persist into adulthood.
When Treatment is Necessary
Diagnosing astigmatism in children involves a comprehensive eye examination. Eye care specialists use tests such as visual acuity tests, where children identify letters or symbols on a chart, and refraction tests to measure how light bends as it enters the eye. Keratometry, a test that measures the cornea’s curvature, is also used. These evaluations help determine the type and degree of astigmatism.
Treatment for astigmatism is important to prevent complications like amblyopia, or “lazy eye,” which can lead to permanent vision impairment if not addressed early, and also helps improve academic performance and reduces discomfort from eye strain. The most common treatment involves corrective lenses, with eyeglasses being the primary choice for children. These glasses contain cylindrical lenses designed to counteract the eye’s irregular curvature, ensuring light focuses correctly on the retina. For older children and teenagers, contact lenses, specifically toric lenses, may offer an alternative. Refractive surgery is typically considered for adults and is rarely an option for children, as the goal of treatment is to correct vision, not to change the underlying eye shape.
Importance of Regular Eye Exams
Regular, comprehensive eye exams are necessary for all children, especially those with a family history of eye conditions or a diagnosed case of astigmatism. Eye care professionals recommend children have their first eye exam by age one, another around age three, and again before starting kindergarten or first grade. Annual check-ups are generally advised.
Ongoing monitoring is important to track changes in astigmatism, adjust prescriptions as needed, and ensure proper visual development. Uncorrected astigmatism can lead to long-term consequences, including permanent vision impairment, headaches, eye strain, and potential learning difficulties in school due to blurred vision. Early detection and consistent follow-up care help mitigate these risks, allowing children to maintain healthy vision as they grow.