Noticing your child squinting at the television or holding books unusually close can generally mean one thing: it’s time to visit their eye doctor.

Astigmatism and myopia are 2 common refractive errors affecting children today. While both cause blurry vision and eye strain, they’re fundamentally different conditions that require distinct treatment approaches.

Myopia leads to blurry distance vision, while astigmatism can lead to blurry vision at all distances. Other key differences include:

• Underlying cause 
• Progression patterns 
• Visual symptoms 
• Age of onset

Staying on top of your child’s health includes keeping up with annual eye exams. The sooner we identify any concerns, including refractive errors, the sooner we can take action.

What Is Myopia?

Better known as nearsightedness, myopia occurs when your child can see nearby objects with ease, but distant objects, such as the TV or whiteboard, appear blurry. It happens when the eye grows too long or when the cornea is too curved. As a result, when light enters the eye, it focuses in front of the retina instead of directly on it, hence blurry distance vision.

With more screen time and less exposure to natural light, myopia is on the rise, particularly in children, as it usually begins in childhood and tends to worsen over time.

Watch for these common indicators of myopia:

• Sitting too close to the television or computer screen
• Complaints of headaches or eye strain
• Difficulty seeing the board at school
• Holding books or devices very close to their face
• Frequent eye rubbing

Children with myopia typically find it easy to focus on tasks like reading or drawing, but struggle when it comes to seeing the board or keeping their eye on the ball during recess. Because children with myopia may struggle to see clearly during physical activities, they might feel less confident participating. Combined with less time outdoors, this could contribute to myopia progression.

What Is Astigmatism?

Astigmatism stems from an irregularly shaped cornea or lens. Instead of being perfectly round, the cornea or lens has a more oval shape, similar to a football. This irregularity prevents light from focusing properly on the retina, resulting in blurry or distorted vision, typically at all distances.

Unlike myopia, which has a single focal point in front of the retina causing distance vision to appear blurry, astigmatism involves two focal points—either in front of the retina, behind it, or one of each. This causes the eye to constantly shift focus between these two points, leading to symptoms like headaches, eye strain, and visual blur. The goal of vision correction is to align both focal points directly onto the retina, and the treatment depends on where those focal points fall.

Children with astigmatism might experience:

• Eye strain and fatigue
• Headaches, especially after reading or close work
• Difficulty with night vision
• Squinting or tilting their head to see better
• Trouble distinguishing between similar letters like “H” and “N”

Because astigmatism affects vision at all distances, children might not realize their vision isn’t normal. They may adapt by squinting or tilting their head to find the clearest point of focus.

This is precisely why annual routine eye exams play a monumental role in children’s vision, and in turn, their learning and development. The sooner we detect these concerns, the better we can support them.

Astigmatism vs Nearsightedness

Though the changes in eye shape may seem subtle, they cause important differences between astigmatism and myopia in how they affect vision:

• Visual acuity patterns: With myopia, close-up vision remains clear, and distance vision is blurry. Astigmatism can cause blurry or distorted vision at all distances, depending on its severity.
• Underlying cause: Myopia develops because the eye is too long or the cornea is too curved. Astigmatism stems from an irregular, oval cornea or lens. 
• Progression patterns: Myopia often worsens during childhood and adolescence, while astigmatism can remain stable in many children, but it may also change over time, especially during growth spurts, after surgery, or with eye disease (e.g., keratoconus). 

• Visual symptoms: With myopia, vision becomes blurrier as distance increases. With astigmatism, blurriness and distortion stay the same, regardless of the distance. 
• Age of onset: Myopia usually develops between the ages of 6 and 14 and often worsens during adolescence, while astigmatism is often present from birth, though it can also change or appear later in life.

On a greater note, children can have both conditions simultaneously. When this occurs, they may experience symptoms from both myopia and astigmatism, underscoring the importance of routine exams for an accurate vision prescription.

How to Treat Astigmatism

A better way to frame this is how we correct or manage astigmatism. Treating a refractive error tends to push the notion that we can go in and alter the eye’s shape, which isn’t the case.

The good news is that we can easily correct astigmatism with a few options. It’s our role to find the option that aligns with your child.

Glasses

Glasses are likely the treatment people are most familiar with. These have cylindrical lenses that correct the irregular curvature, allowing light to focus properly on the retina.

Modern lens technology has made glasses lighter, more durable, and more comfortable for children. The fun part is always finding a new pair of frames!

Contact Lenses

Toric contact lenses can be a great option for older children who are active or prefer the “no glasses” look. That said, contact lenses require proper hygiene and care, making them ideal for older, responsible children.

Orthokeratology Lenses

Orthokeratology (ortho-k) lenses are specialty contacts that are worn overnight. As you sleep, these lenses gently reshape the cornea, providing clear vision during the day without glasses or contact lenses.

How to Treat Myopia

We can’t “cure” myopia, but we can prevent it from worsening by using myopia control therapies. The sooner we start, the better, as children’s eyes tend to be more responsive to these treatments.

Correcting Myopia

Comfortable and easy to maintain, glasses are a tried and true option for managing myopia in children (and people of all ages).

Contacts can be a great option for older children who are ready to take on the responsibility of contact lens care. Daily lenses are a great option for first-time wearers.

Myopia Control Strategies

Whereas standard glasses and contacts focus on correcting the refractive error, myopia control therapies focus on slowing its progression. Here’s a closer look at the therapies our clinic offers:

• Low-dose atropine eye drops 
• Orthokeratology lenses 
• Multifocal contact lenses 

A consultation with our team helps us tailor the right treatment plan for your child.

Support Strong, Healthy Vision

If you notice your child squinting or rubbing their eyes, it might be time for an eye exam. Thankfully, we can correct refractive errors, including astigmatism and myopia, with the right prescription and strategies.

Creating a supportive environment for your child’s eye health involves more than making sure they wear their glasses or contacts. It also means working closely with their eye doctor. Connect with our Eye Lab Doctors of Optometry team to book an appointment for your child’s routine eye exam today.