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Michael Cole, OD, Child and Family Eyecare Center

“My child is farsighted. So, they can’t see up close? Or far away? Which one is it?” I hear this a lot from parents in our office, and it’s not as simple of an explanation as you might think.

Nearsightedness, or myopia, is fairly easy to understand, much more so than farsightedness. In myopia, our eyes are focused too close to us, making it hard to see things far away. The higher the myopic prescription, the closer an object has to be before being able to see it clearly. In most cases, this is easily corrected with glasses, contact lenses or a refractive surgery, such as LASIK. However, being farsighted or hyperopic doesn’t mean the opposite (that one can see far away but not up close). However, this is what most people think.

Our eyes are designed to see clearly when we are viewing distant objects (i.e. driving). They should be completely relaxed while doing so. In order to see up close, we must use a muscle inside our eyes. Doing so for long periods of time causes eye strain, fatigue and can lead to headaches and blurry vision.

If a person is farsighted, they often see clearly far away, but not without some effort. In order to see clearly even while looking far away, a farsighted person must constantly engage the muscle in the eye, as if they were looking at something up close. The more farsighted, the more effort needed by the eye. If a farsighted person has to look up close, their eyes have to focus even harder in order to make things clear. If a farsighted person is not able to focus hard enough, or sustain that focus long enough, they can’t see clearly at any distance.

Children can focus their eyes much easier than adults, which makes it possible for hyperopic children to see clearly while adults may not be able to. With some effort, they may be able to pass routine vision screenings at school or the pediatrician’s office, which are always performed for distance vision. However, while adults may wear glasses to help ease the burden on the eye, the uncorrected child’s visual system never gets a break. They are constantly working to make things clear, especially while looking up close.

A 2015 study published in the Journal for the Academy of Ophthalmology identifies what effects uncorrected hyperopia might have on children’s reading. This study administered the Test of Preschool Early Literacy (TOPEL) to 492 children between ages 4 and 5. The results were compared between hyperopic children and children with “normal” vision. This study conclusively showed that hyperopic children had reduced visual acuity up close, reduced depth perception and performed significantly worse on the test of early literacy.

Farsightedness is only one example that may cause vision problems in children. It’s important for parents to understand that comprehensive eye exams are necessary for each and every child, even if they haven’t said anything. The American Optometric Association (AOA) recommends an eye exam in children who are symptom-free at 6 months of age, age 3 and annually after entering school. Help us take good care of your children’s eyes and schedule an appointment today.