Hyperopia in Children: When to Adjust Eyeglass Prescription

Hyperopia in children

Dear Dr.
Ko,
My daughter is 7 years old and was diagnosed two years ago with high hyperopia and astigmatism (both eyes measured over +600 diopters of hyperopia and over +100 diopters of astigmatism after dilation).
Following the doctor's recommendation, she has been wearing glasses with the prescribed prescription, which corrected her vision to approximately 0.8.
This year, during her check-up, her vision with glasses measured around 1.0.
Given that her corrected vision has improved, I would like to know if it is possible to prescribe glasses with a lower prescription.
Should the new prescription be based on the measurements taken before dilation or after dilation? Thank you for your guidance.

Mrs. Hong, 30~39 year old female. Ask Date: 2005/07/11

Dr. Ke Meilan reply Ophthalmology

If you want to induce myopia (to counteract hyperopia), you can use the prescription before dilation, but in practice, it is essential to review the patient's data to make a decision.

Reply Date: 2005/07/11

More Info

When it comes to understanding hyperopia (farsightedness) in children, particularly in your case with your 7-year-old daughter, there are several important factors to consider regarding when to adjust her eyeglass prescription.

Firstly, it’s great to hear that your daughter’s corrected vision has improved to 1.0 with her current glasses. This indicates that her visual acuity is functioning well with the prescribed lenses. However, the decision to adjust her eyeglass prescription should be based on a combination of her current visual performance, her comfort with the glasses, and the results of her eye examinations.

In children, hyperopia can often be compensated for by the eye's natural focusing ability, especially if the degree of hyperopia is not excessively high. However, as children grow, their eyes also grow, and their visual needs can change. Therefore, regular eye examinations are crucial.
Regarding the prescription adjustment, it is generally recommended to use the measurements taken during the cycloplegic (dilated) examination, which is what you refer to as the "散瞳後之度數." This is because the use of cycloplegic drops temporarily paralyzes the ciliary muscle, allowing for a more accurate assessment of the refractive error without the influence of accommodation (the eye's ability to focus on near objects).
If your daughter has been diagnosed with high hyperopia (over +5.00 diopters) and astigmatism, and her current glasses are providing good vision, it may be appropriate to consider a reduction in the prescription if her eye doctor agrees. However, it is essential to ensure that her visual development is not hindered.
Here are some considerations for adjusting her prescription:
1. Visual Acuity: If she can see well with her current prescription and is comfortable, this is a positive sign. However, if she experiences any difficulties, such as eye strain, headaches, or difficulty focusing, it may be necessary to reassess her prescription.

2. Eye Examination Results: Regular eye exams should be conducted to monitor her refractive error and overall eye health. If her hyperopia has decreased significantly, a new prescription may be warranted.

3. Age and Development: As children grow, their visual needs change. It’s crucial to monitor her vision regularly, as her eyes may naturally become less hyperopic as she matures.

4. Comfort and Fit: If her current glasses are causing discomfort or if she is not wearing them consistently, it may be time to consider a new pair that fits better or has a more suitable prescription.

5. Consultation with an Eye Care Professional: Always discuss any changes with her eye care provider. They can provide personalized recommendations based on comprehensive eye exams and her specific visual needs.

In conclusion, while it is possible to consider a change in her eyeglass prescription, it should be done cautiously and in consultation with her eye care professional. Regular follow-ups are essential to ensure her visual development is on track and to make any necessary adjustments to her prescription as she grows.

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