How to Decipher the Results of Your Child's Refraction Eye Exam

What Happens in a Pediatric Refraction Test?

A refraction test is an essential part of a pediatric eye exam. This test evaluates how well your child can see by assessing how light interacts with the retina, the nerve layer located at the back of the eye. The results of this test are key in determining whether your child needs eyeglasses or another form of vision correction. There are different types of refraction tests your child’s eye doctor may perform, including:

• Computerized Test: This test uses advanced technology to measure the amount of light that passes through your child’s eyes, helping to evaluate their vision clarity. 

• Manual Light Reflex Test: In this test, the doctor shines a light into each eye and measures how much light is reflected from the retina. This provides valuable insight into the overall quality of your child’s vision. 

• Phoropter Test: During this exam, your child will look through a device called a phoropter, which is placed in front of their face. They will then view an eye chart from a distance of 20 feet and identify the smallest row of letters or pictures they can clearly see. 

Since children often focus on nearby objects instead of those further away, dilation is commonly used during the test to ensure accurate results. To achieve this, optometrists may use cycloplegic refraction, which involves eye drops that temporarily relax the focusing muscles of the eye, providing a precise reading of farsightedness and refractive errors.

How Often Your Child Should Get an Eye Exam

During your child’s first year, it’s recommended they see an eye doctor once between 6 and 12 months to ensure their eyes are properly aligned and to screen for conditions like congenital cataracts, high farsightedness, and early amblyopia. The next eye exam should take place between ages 3 and early kindergarten, a crucial period to identify uncorrected vision problems, binocular vision issues, and amblyopia when treatment is most effective.

Once your child starts school and completes a baseline vision exam, which confirms clear, comfortable eyesight for reading and close-up activities and establishes a prescription baseline, annual eye exams are advised. These yearly visits help maintain up-to-date prescriptions during rapid growth phases, track the progression of nearsightedness, and detect signs of digital eye strain.

How Are Refractive Errors Diagnosed in Young Children?

When an eye doctor tells you that your child has 20/20 vision, it means there are no refractive errors present and their eyesight is considered normal. A “zero” on your child’s chart indicates that their vision is sharp and doesn't require corrective lenses. However, refractive errors are common in children, and they simply mean that light passing through the eye isn’t focusing properly on the retina. The most common refractive errors include:

• Myopia (nearsightedness) makes it hard to see objects clearly at a distance, such as the writing on a classroom board. With myopia, light is focused in front of the retina, rather than directly on it. 

• Hyperopia (farsightedness) makes it difficult to focus on nearby objects. In hyperopia, light is focused behind the retina. Some children may have mild hyperopia in their early years, which can sometimes resolve naturally as they grow older. 

• Astigmatism causes blurry vision at both near and far distances. Astigmatism occurs when the cornea is misshapen, often resembling an oval rather than a round shape. This irregularity causes light to be refracted at multiple points, making it difficult to achieve clear vision. Astigmatism can be present from birth or develop later due to injury or illness. It’s also possible for a child to have astigmatism along with either myopia or hyperopia. 

Common Parental Worries

Taking your child to see an eye doctor can be a stressful experience, especially when you don’t know what to expect. Here are some of the most common concerns parents have when scheduling eye exams for their children. 

Does my child really need this test?

If you’ve noticed your little one squinting at the TV, holding tablets inches from their face, or complaining of headaches after school, those behaviors can all point to an uncorrected refractive error. A pediatric refraction pinpoints whether the eyes are focusing light properly so problems like nearsightedness, farsightedness, or astigmatism don’t sneak up on learning and play.

What actually happens in the exam room?

The whole process only takes about 15 minutes and is totally painless. Here’s a quick, simple rundown of what will occur:

1. Retinoscopy/Autorefractor – The doctor shines a light or uses a hand‑held device while your child looks at a target; no answers required. 

2. Phoropter choices – Older kids look through the familiar lens dials and simply pick “Which is clearer, 1 or 2?” 

3. Cycloplegic drops (if needed) – A mild, temporary eyedrop keeps the focusing muscles from “cheating,” giving the most accurate prescription for fast‑changing young eyes. 

What do the numbers on the Rx slip mean?

The terms on your child’s prescription can be confusing. We’ve provided a short table to help you, but you can always bring the slip to any eyecarecenter location and we’ll translate it again, no judgment.

• Sphere (SPH): How strong the lens must be to sharpen vision. Negative means nearsighted, while positive means farsighted. 

• Cylinder (CYL): Extra power to correct astigmatism (football-shaped cornea). 

• Axis: The direction the astigmatism correction sits in the lens. 

• OD / OS / OU: Right eye / left eye / both. 

Next Steps After Results

When your child’s exam results are ready, the optometrist will explain the prescription in simple terms—what the numbers mean, how they affect near and far vision, and whether there’s any urgency in addressing them. It’s always a good idea to ask for a printed copy of the results or take a photo, so you can easily share them with teachers or caregivers. If a refractive error is found, eyeglasses are usually the first recommendation. Your doctor will suggest durable, child-friendly frames and impact-resistant lenses to accommodate your child’s active lifestyle.

As your child gets older, they may be interested in trying contact lenses. Daily disposable lenses can be suitable for children as young as 8-10 years old, especially for sports or to boost self-esteem. Your optometrist will review the various types of contact lenses available and help choose the best one based on your child’s age, preferences, and activities.

Finally, a follow-up appointment is typically scheduled within a year to monitor your child’s vision and any changes in their prescription. Regular check-ups are essential to ensure your child has the correct prescription as they grow, supporting their success in school, sports, and social settings.