Do Preschoolers Need Glasses?

We previously mentioned how a child's eye grows between birth and age 5. Once a child reaches their fifth birthday (hello, Chuck E. Cheese!) the eyeball has acquired adult dimensions. All along, the optics of the eye are frantically trying to keep up with the dynamic anatomy. Beyond age 5 the anatomy remains stationary but the optics continue to progress. Most refractive errors stabilize around age 30.

Following this explanation, the refractive error in infants and toddlers is very liquid. Most preschoolers are hyperopic (farsighted) because their growing eye is still a bit short. This physiologic hyperopia tends to disappear by first grade or so. Doctors traditionally declined to prescribe glasses for this age group because:

• Eyeglasses are expensive


• The child won't wear them


• The child involuntarily relies on their abundant accommodation (near focusing power) to provide clear focusing


• The child won't wear them


• Nobody has ever performed a controlled clinical research study on the topic, and finally


• The child won't wear them!

Vision scientists from the University of California San Diego wanted to know if spectacle wear made any measurable behavioral difference in preschoolers. They have published the findings of their research in the Archives of Ophthalmology.

This is the first controlled study to document that preschool children with uncorrected refractive errors score significantly worse on visual-motor integration and cognitive ability tests. Within six weeks of wearing glasses, the visual-motor function of the children wearing eyeglasses was similar to normal children. Since low visual-motor skill scores correlate with lower academic achievements, the authors conclude that spectacle correction might lead to improved cognitive and verbal performance.

Before heading off to the optical shop it's important to note that the study only evaluated children between ages 3-5 with +2.00 diopters or more of hyperopia. Today a refractive error less than +2.00 diopters would still probably not warrant spectacle correction.

Astigmatism (excessive corneal curvature) is a very different matter. Most eye doctors would correct for astigmatism, especially if it was present in one eye only. A significant refractive error between the two eyes could lead to amblyopia (lazy eye) in the blurrier eye.

Parents can expect to hear more about the results of this groundbreaking study. We will keep you up-to-date here at WebMD if changes occur to published eyecare recommendations.

REFERENCE: Archives of Ophthalmology, February 2008, pages 252-258.

Related Topics:

• WebMD Video: Preschool Eye Exams: Get Kids Tested Early
• Your Child's Development: Age 2-5

Technorati Tags: preschool, glasses, education, learning, eye health