astigmatism in 4 yr old

[rv30]

My son who is 4.3 yrs old has been recently diagonised as astigmatic. His cylindrical power is 2.75 in the right eye with 10 degree axis and left eye is 2.5 with 180degree axis, however, the opthalmologist has almost halved the power to 1.75 and 1.5 respectively with no change in the axis.
My queries are:
1.why has he halved the power?
2.Should I consult a paediatric opthalmologist to get an accurate evlauation?
3.Will his condition stabilise or deteriorate with age?
4. Are environmental factors responsible for his condition?

The reason for the last question being tht my son hasnt shown any specific eye prob related symptom except for the last 10 days in which he complained of eye pain just once and he loves to read and write and play cricket. I never found a problem in his visual ability except for the past 10 days. Is this sudden onset of eye strain related to astigmatism or some other eye problem.
Please reply soon as soon as possible.

[rv30]

Thanks for the reply. Iam still unsure about the recommended power coz the opthalmologist said that he has reduced the power so that my son gets comfortable with wearing the glasses and then gradually the doc will increase the power. One more thing I wanted to know was: is it possible to get an accurate eye test for children without pupil dilation, my son's pupil's werent dilated for the exam so will tht cause some error in the readings?

[Michael J Kutryb, MD]

The eye pain would have nothing to do with the astigmatism - but could be due to something in his eye or dry eyes or allergies - again unrelatedt to astigmatism.  The astigmatism is mostly genetically determined.  The amount and axis can change over time somtimes getting better and sometimes worse.  In general, with this significant amount, however, he will most likely have to wear glasses for a long time.  I don't know why the doctor changed the astigmatism correction other than maybe he was able to get a better reading now that your son is older.  If your ophthalmologist seems comfortable with taking care of your son and there is no strabismus or lazy eye, then you can stay with current doctor.  

MJK MD