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Vision 101: Screening for Farsightedness in Children (Hyperopia)

Hyperopia, also known as farsightedness, is a refractive error of the eye in which the eye has trouble focusing. When a child is farsighted, distant objects look somewhat clear, but close objects appear more blurred. The interesting thing about farsightedness is that most children have it! However, they do not actually experience blurred vision. Why? Because children’s eyes are able to bend the light rays and place them directly on the retina. So as long as the farsightedness is not too severe, hyperopic children will have clear vision for seeing objects at a distance and up close. And as the eye grows and becomes longer, the hyperopia lessens and continues to decrease during preteen years. But while farsightedness in children is common and often doesn’t cause issues, more severe cases can result in vision loss.

When Farsightedness in Children is Severe

When farsightedness in children is severe, the eye’s focusing muscles may not be able to properly focus and there is an increased risk for amblyopia, which can cause vision loss among children. In this case, correction with converging or plus (+) power glasses may be necessary, especially when the farsightedness is paired with accommodative esotropia (commonly referred to as crossed eyes).

How to Screen for Farsightedness in Children 

There are no current national guidelines that specifically recommend near vision acuity screening for farsightedness or that describe how near vision acuity screening should be conducted. However, there are two recommended procedures that can be used if you are mandated to perform a near vision screen:

Using age-appropriate optotypes for preschool-aged children or children aged 6 and older:

  1. Screen with both eyes open using the line a child must pass on a distance chart according to the child’s age (i.e., the 20/32 line for students aged 6 years and older) to identify any blurring of near acuity.
  2. Screen monocularly using the same procedures you would use when using a distance threshold

You may be wondering if the plus-lens test can be used instead of a near vision acuity chart. The Prevent Blindness Position Statement on School-Aged Vision Screening and Eye Health Programs states that plus-lens testing is not an evidence-based approach for detecting children with significant refractive errors and is an unacceptable vision screening technique.

Early detection of vision issues can lead to an effective intervention and help to restore proper vision. Remember that young children rarely complain when they can’t see well because to them, it’s normal. That’s why screening is so important.

Shop MacGill’s selection of hand-held near acuity charts, near acuity charts for cabinets, and illuminated cabinets and accessories.

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