Astigmatism

[PEGrimes]

My 4 year old, soon to be 5 year old son, did not pass his eye exam at the doctors office and she recommended I get his eyes checked. He has never complained of blurry or fuzzy vision, no headaches, sensitivity to light or etc. He went to an optometrist today and results were:

OD  +0.25 (SPH)  -1.75 (CYL) Axis 005
OS  +0.25 (SPH)  -2.00 (CYL) Axis 155

During his eye exam at the doctors office, his issue was seeing far away. If I'm correct, this means he slightly farsighted and I very surprised with the number for the the astigmatism. I'm considering getting a second opinion before I buy and glasses, does anyone have a opinion on what I should do. Thanks in advance!!!

[JohnHaganMD]

I would also agree that if this was an accurate refraction done under dilating drops (cycloplegic refraction) that glasses are indicated.

JCH MD

[SoftwareDeveloper]

Astigmatism indicates the eye isn't spherical, that it is more shaped like an American football with a difference lens power at one angle compared to another. The sphere (the first number) gives the correction needed for the eye in 1 direction, while the astigmatism (2nd number) indicates the difference in correction needed at a different angle. The power of the eye varies gradually in between those two angles.

In this case the OD prescription shows a correction of +0.25 is needed in one direction while at a different angle a correction of (+0.25 + (-1.75)) = -1.5 is needed. In the OS prescription +0.25 is needed in one direction, and (+0.25+(-2))= -1.75 is needed in the other direction.  A positive number indicates a hyperopic (farsighted) correction while a negative number indicates a myopic (nearsighted) correction. Although at one angle his eyes are slightly hyperopic, most of the eye has a shape that makes them myopic. On average both his eyes are nearsighted rather than farsighted, which makes sense given his main issue is seeing far away.  

[CBCT]

I would go for the glasses.  A second opinion is not necessary.  New technology makes refraction highly reliable.  Even if the glasses are not perfect, your optometrist will work with you to make any necessary adjustments.  You shouldn't be surprised that your child never complained about vision. A child likely assumes that his vision is normal.  Astigmatism makes vision blurry at all distances.  Poor vision will impair his ability to read, and to see the front of the classroom.  Best wishes.