Astigmatism in children causes symptoms and best treatment methods

Astigmatism in children is one of the most common vision problems, yet many parents don’t realize it can appear at a very young age. It often causes blurred vision or frequent headaches, and if left undiagnosed, it can seriously affect a child’s focus at school and their daily life. In this, we’ll cover everything you need to know about astigmatism in children: its causes, symptoms, diagnostic methods, and the latest treatment options—whether through glasses, contact lenses, or in some cases, surgical intervention. We’ll also share practical tips to help parents support their child, ensuring they live a normal life and avoid complications such as lazy eye or long-term vision problems.

Is Astigmatism the Same as Nearsightedness or Farsightedness?

No, astigmatism is different.

In nearsightedness (myopia) or farsightedness (hyperopia), the problem comes from where the image focuses inside the eye.
In astigmatism, the image gets blurred in multiple directions because the cornea or lens has an irregular curve.

Can Astigmatism Be Noticed Without an Eye Exam?

Parents might notice some signs, such as:

Tilting the head or squinting while reading.
Holding books or a phone very close.
Bumping into things or being clumsy because of unclear vision.

But a proper diagnosis can only be made by a pediatric eye specialist.

Do All Degrees of Astigmatism Require Glasses?

Not always:

Very mild astigmatism (less than 0.5 D) might not need correction.
Any degree that affects vision or causes symptoms (headache, blurred vision) → needs glasses or contact lenses.

❌ What If My Child Refuses to Wear Glasses?

This is very common at first.
Tips for parents:

Choose a fun, stylish frame your child likes.
Explain that glasses will help them see like their friends.
Praise and encourage them when they wear the glasses.

Does Astigmatism Affect School Performance?

Yes, it can:

Difficulty focusing on the board or books.
Poor academic performance.
Lack of interest in studying due to eye strain.

⚠️ What Happens If Astigmatism Is Left Untreated?

The main risk is amblyopia (lazy eye) → the brain may stop using the weaker eye, even if it’s corrected later.

Can Astigmatism Be Inherited?

Yes. Genetics play a big role, so children may pass it on to their own kids in the future.

Regular vs. Irregular Astigmatism – What’s the Difference?

Regular astigmatism: Smooth and even curve → corrected easily with glasses or contacts.
Irregular astigmatism: Uneven surface (scars, keratoconus) → needs special lenses or surgery.

Will My Child Need to Change Glasses Often?

Yes, because vision changes as children grow.

Eye exams are recommended every 6–12 months.
Prescription may need adjustment regularly.

Are There Eye Exercises to Treat Astigmatism?

No exercise can correct the irregular curve.

Eye exercises may reduce eye strain but don’t cure astigmatism.
The main treatment is glasses or contacts.

Can Astigmatism Go Away on Its Own in Children?

Not really.

Sometimes it improves as the child grows.
But it may also remain the same or get worse.
Glasses or contacts are important to protect vision and prevent lazy eye.

⚽ Can Children With Astigmatism Play Sports With Glasses?

Yes, absolutely.

If glasses are uncomfortable, older children may switch to contact lenses (under medical supervision).

Do Foods or Vitamins Cure Astigmatism?

No, diet can’t fix astigmatism.
But healthy nutrition supports eye health:

Vitamin A: carrots, spinach, sweet potatoes.
Vitamin C: oranges, strawberries, lemons.
Omega-3: fatty fish like salmon and tuna.

Does Astigmatism Get Worse in Children?

Not always.

About 23% of infants (6–12 months) have astigmatism.
By age 5–6, this number drops to around 9%.
So in some kids, it improves naturally. Still, regular check-ups are essential.

❓ Can Astigmatism Cause Blindness?

No, astigmatism does not cause blindness.
It only blurs vision and may cause headaches or eye strain.
⚠️ If untreated, it can lead to lazy eye or strabismus in rare cases.

Can Astigmatism Improve in Children?

Yes, especially with:

Early diagnosis.
Correct treatment (glasses or contacts).
Regular follow-ups with a pediatric eye doctor.

Does Astigmatism Cause Strabismus (Crossed Eyes)?

Usually, no.
But if one eye has much higher astigmatism than the other, the weaker eye may develop strabismus or lazy eye.

Stages of Astigmatism in Children

Mild (less than 1.0 D)
- Often no symptoms, sometimes only noticed in an eye exam.
- May not need treatment.
Moderate (1.0 – 2.5 D)
- Clear symptoms: squinting, headaches, trouble reading.
- Glasses are needed to prevent lazy eye.

(Severe stage content can follow if needed)

3- High Stage (Severe Astigmatism)

Degree: More than 2.5 or 3 diopters.
Symptoms: Very blurry vision even at close distances, persistent headaches, amblyopia (lazy eye), poor academic performance.
Treatment: Special glasses or contact lenses + close follow-up with the ophthalmologist.

4- Complication Stage (If left untreated)

Amblyopia (Lazy Eye): The weak eye doesn’t learn to see properly.
Depth Perception Disorder: Difficulty judging distances and depth.
Academic or Behavioral Issues: Due to poor vision and eye strain.

Causes of Astigmatism in Children

Irregular corneal shape: Instead of being perfectly round, the cornea is oval, so light doesn’t focus correctly on the retina.
Genetic factors: If one or both parents have astigmatism or myopia, the child is at higher risk.
Congenital problems: Some babies are born with astigmatism.
Eye injuries or surgeries: Rare in children, but can alter corneal shape.
Associated refractive errors: Such as myopia or hyperopia, which make the symptoms more noticeable.

In most cases, childhood astigmatism is congenital (from birth), not caused by screens or daily habits. However, neglecting treatment can lead to serious complications like lazy eye.

Degrees of Astigmatism in Children

Mild Astigmatism: Less than 1 diopter.
Moderate Astigmatism: 1–2 diopters.
Moderate to High: 2–3 diopters.
High Astigmatism: More than 3 diopters.

Key Notes for Parents

Mild astigmatism (<1 D) is usually normal and doesn’t require treatment.
Moderate to high astigmatism must be corrected with glasses to prevent lazy eye.
Regular eye check-ups are essential, especially if vision problems run in the family.

Minimum Degrees of Refractive Errors in Children

1. Myopia (Nearsightedness):

Mild: Less than -3 D
Moderate: -3 to -6 D
Severe: More than -6 D
Earliest noticeable degree: Around -0.50 D

2. Hyperopia (Farsightedness):

Mild: Up to +2 D
Moderate: +2 to +5 D
Severe: More than +5 D
Earliest noticeable degree: Around +0.50 D

3. Astigmatism:

Earliest noticeable degree: Around 0.50 D

Types of Astigmatism in Children

1. Regular Astigmatism

Cause: Uneven corneal curvature (two visual axes, one weaker).
Most common and can be corrected with glasses or contact lenses.
Subtypes:
- With-the-rule: Steeper curve in the vertical axis.
- Against-the-rule: Steeper curve in the horizontal axis.
- Oblique: Axis is tilted (not vertical or horizontal).

2. Irregular Astigmatism

Cause: Uneven corneal surface (bumps or scars).
Possible causes: Eye injury, keratoconus, post-surgery or inflammation.
Harder to correct with glasses → often requires rigid contact lenses or medical intervention.

3. Simple Astigmatism

Only one axis has abnormal refraction (myopia or hyperopia), the other is normal.
Example: Part of the image focuses on the retina, the other in front or behind it.

4. Compound Astigmatism

Both axes have abnormal refraction but to different degrees.
Subtypes:
- Compound Myopic Astigmatism: Image forms in front of the retina in both axes.
- Compound Hyperopic Astigmatism: Image forms behind the retina in both axes.

5. Mixed Astigmatism

One axis is myopic, the other hyperopic.
Result: The image splits between in front of and behind the retina → vision is highly blurred.

⚠️ Symptoms of Astigmatism in Children

Blurred or distorted vision for both near and far objects.
Frequent headaches, especially after studying or screen time.
Eye strain (excessive blinking, rubbing the eyes).
Tilting the head or closing one eye to see better.
Difficulty reading or following words in text.
Sometimes double vision in severe cases.
Avoiding activities that require visual focus (coloring, puzzles, educational games).

Diagnosis of Astigmatism in Children

1. Medical History

Family history of vision problems.
Child’s complaints: headaches, blurry vision, head tilting, squinting.
School performance and any difficulties in reading or writing.

2. Clinical Eye Examination

Checking eye alignment (for squint or strabismus).
Observing if the child gets too close to objects.
Assessing light reflexes and pupil response.

3. Visual Acuity Test

For older children: letter or picture charts.
For younger children: picture-based tests or object-following.

4. Refraction Test

The most important test to determine the degree of astigmatism.
- Autorefractor: Automated device to measure refraction.
- Retinoscopy: Manual test with light and lenses.
Sometimes dilating drops are used to get accurate measurements.

5. Corneal Tests (Keratometry / Topography)

Measures corneal curvature.
Helps detect if astigmatism is regular or irregular (e.g., keratoconus).

6. Fundus Examination

To rule out problems related to the retina or optic nerve.

When Should Parents Take Their Child for an Eye Exam?

Family history of strabismus or astigmatism.
Getting too close to TV or books.
Frequent unexplained headaches.
Signs of amblyopia (lazy eye) or noticeable vision loss.

❓ Can Astigmatism Be Treated Without Glasses?

1. Contact Lenses (Toric Lenses)

Special lenses designed to correct astigmatism.
More suitable for teenagers who can maintain hygiene.
Not usually recommended for younger kids except in special cases under medical supervision.

2. Orthokeratology (Ortho-K) Lenses

Worn at night, removed in the morning.
Temporarily reshape the cornea, providing clear vision during the day.
Requires close monitoring by an eye specialist.

3. Laser Surgery (LASIK, FemtoLASIK)

A permanent solution for adults.
❌ Not suitable for children, as their eyes are still growing.
Usually considered after 18 years old when vision is stable.

4. Intraocular Lens Implantation (ICL)

Used in certain adult cases where laser isn’t an option.
Rarely performed in children.

5. Medications

No medicine can correct astigmatism.
Eye drops may be prescribed for:
- Pupil dilation during exams.
- Lubrication for dry eyes.
- Treating allergies or inflammation.

Main Treatment for Astigmatism in Children

Glasses: The safest and most effective option, with cylindrical lenses.
Contact lenses: Possible for older children under supervision.
Lazy eye management: Eye patching or vision therapy if amblyopia is present.
Regular follow-ups: Essential since astigmatism may progress as the child grows.

❌ Can Children Have Laser Surgery for Astigmatism?

No. Laser eye surgery is not performed on children because their eyes are still developing.
Requirement: vision must remain stable for 1–2 years, which usually doesn’t happen before age 18.
For kids, treatment is mainly glasses or contact lenses.

Types of Surgery for Astigmatism in Children (Rare Cases)

1. Intraocular Lens Implantation (ICL/IOL)

For very severe cases with high refractive error.
An artificial lens is implanted inside the eye.
Considered only if glasses don’t improve vision enough.

2. Corneal Transplant (Keratoplasty)

For astigmatism caused by corneal damage, scarring, or keratoconus.
Types:
- Penetrating keratoplasty (PK): Whole cornea replaced.
- Lamellar keratoplasty: Only part of the cornea replaced.
Glasses or contact lenses may still be needed after surgery.

3. Corneal Laser Surgery (LASIK – PRK – SMILE)

Popular for adults.
❌ Not done in children.

4. Cataract Surgery with Lens Implantation

If congenital cataract causes astigmatism.
Cloudy natural lens is removed and replaced with an artificial one.

⚠️ Important Note:

Most children are treated with glasses or contact lenses.
Surgery is the last option and only for rare, severe cases.
The decision depends on:
- Degree of astigmatism.
- Underlying cause (keratoconus, trauma, cataract).
- Age of the child.
- Whether glasses provide sufficient correction.

Helpful Eye Exercises (Supportive, Not Curative)

20-20-20 Rule: Every 20 minutes of screen use, look at something 20 feet away for 20 seconds.
Blinking exercise: Encourages frequent blinking, especially during screen time → prevents dryness.
Tracking exercise: Follow a moving toy or pen with the eyes (left-right, up-down). Strengthens eye muscles but doesn’t cure astigmatism.
Lazy eye therapy: Patching the stronger eye for certain hours daily, if prescribed by the doctor.

Tips for Parents Dealing with Astigmatism in Children

Ensure the child wears glasses consistently.
Choose stylish, comfortable frames so the child enjoys wearing them.
Schedule check-ups every 6–12 months.
Watch for new symptoms like headaches or squinting.
Encourage positive reinforcement, never mock them for glasses.
Provide good lighting for study and limit screen time.
Encourage healthy nutrition (Vitamin A, C, and Omega-3 foods).
Be patient – children often resist glasses at first but adapt with time.

✅ Tips for Parents on Managing Astigmatism in Children

3. Monitor for New Symptoms

Frequent headaches.
Holding books too close to the face.
Persistent tearing or blurry vision.
⚠️ These are warning signs that require an immediate visit to the eye doctor.

4. Provide Emotional Support

Avoid mocking or making negative comments about the glasses.
Praise your child’s appearance with glasses, and encourage siblings or friends to support them.

5. Proper Lighting and Seating

Ensure the child studies in a well-lit environment.
Maintain a safe distance from the TV or mobile devices.

6. Limit Screen Time

Excessive use of tablets and phones increases eye strain.
Create a screen-time schedule appropriate for your child’s age.

7. Healthy Nutrition
Food doesn’t cure astigmatism but supports overall eye health:

Carrots, spinach, broccoli (Vitamin A).
Oranges, lemons (Vitamin C).
Fish like salmon or tuna (Omega-3).

8. Managing Lazy Eye (if present)

Follow the doctor’s instructions, such as patching the stronger eye for certain hours daily to strengthen the weaker eye.

9. Sports and Activities

Children with astigmatism can participate in all sports.
If glasses are uncomfortable during play, contact lenses may be an option (at the right age and under medical supervision).

10. Patience and Consistency

It’s normal for children to resist wearing glasses at first.
With patience, encouragement, and regular follow-ups, they will adapt, and their vision will improve.