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Q. Is it normal for a 4-year-old to have a cylindrical eye power?

Answered by
Dr. Hussein Mohamed Sherif Ahmed Ayoub
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 11, 2022

Hi doctor,

My four-year-old daughter had her first eye test. I was shocked to see that she had cylindrical power in her eyes.

The left eye had a power of 0.75, and the right eye had a power of 2.5. Both are cylindrical, and there is no spherical power in the eyes. The doctor checked her vision, but she could read only 6 / 12 with both eyes, even with lenses. She could not read the last two lines with lenses also.

Is it normal at this age? Will she ever be able to see 6/6? Is 6/12 bad for brain development?

Please help me, doctor.

Thank you.

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#

Hello,

Welcome to icliniq.com.

Did she see 6 / 12 with or without glasses correction?

No, that is not normal for her age. For her age, she should see 6 / 6 with both eyes, but given that she has a cylinder (a condition we call astigmatism) and has never worn glasses before, she might be amblyopic. Amblyopia is a lazy eye condition. Her condition will be treated, and she will gain perfect vision after wearing glasses. She will have to wear glasses all the time. We can do something called cycloplegic refraction at this young age before we prescribe glasses.

I will be happy to help if you need more help.

Thank you.

Hello doctor,

Thanks for the response.

Her vision after wearing glasses was 6 / 12. She has never worn glasses, as we did not know, and we never got her eyes checked. We were shocked to see a cylindrical number that too minus 2.5. The doctor gave her glasses with minus 1.5 and 0.75 cylindrical. With these glasses, she can see 6 / 12. Without glasses, her vision is 6 / 25. Even with glasses, she cannot see the last three lines. She has lazy eyes as she has never worn glasses and never seen the world.

Now my question is,

1) Can lazy eyes be 100 percent treated?

2) What is the success rate at her age?

3) Will she ever see 6 / 6 with glasses?

Please help me, doctor.

Thank you.

#

Hi,

Welcome back to icliniq.com.

I can understand your worry.

Be rest assured that her condition can be cured 100 percent, and it is very successful at her age. Lazy eye treatment in her situation will most probably require only glasses. You should see progress within the next two months. The right eye may or may not require patching therapy later on. Also, please note the cylindrical error will mostly get better with age.

So there is nothing to worry about. She will be okay.

Hi doctor,

Thanks for the response.

So with glasses, she can get 6 / 6 vision for sure? Is it a common problem for children?

One thing I want to know for knowledge's sake is Why she cannot see 6 / 6 with glasses? Is it because she never wore glasses? Am I too late to check her eye? Also, will the cylindrical number decrease as she grows up?

Thank you.

#

Hi,

Welcome back to icliniq.com.

Yes, it is common. Unfortunately, it is often diagnosed accidentally during a routine check-up. She never complained because she is a child and she is seeing but not the best. So that is why we discovered it accidentally.

With glasses at her age, the problem can be addressed early. So do not worry. Her age is optimal for treatment so that she will be good with proper glasses. The glasses you have attached seem to be, as you have said, with the cylinder. So it should do good. Cylindrical errors are common at this age and do improve with age.

Feel free to follow up with me to ensure everything is going correctly as planned.

Thanks and regards.

Hi doctor,

Thanks for the reply.

I got her spectacles today and will make sure she wears them all the time. My other question is, can her cylindrical number also increase as she ages? or will the number remain stable?

Thank you.

#

Hi,

Welcome back to icliniq.com.

The cylindrical number will most probably decrease over time as she grows older. However, there are certain situations when astigmatism will increase.

Is her cylindrical number an inherited condition? Does you or her father have a cylindrical number?

Thanks and regards.

Hi doctor,

Yes. Her father also had a cylindrical number. No one in the family has or had keratoconus. My mother and father wear spectacles with a bit cylindrical and spherical numbers. My mother had - 4 spherical numbers with - 1 cylindrical number in both eyes.

What all situations can increase the number, and how to prevent that?

Please help, doctor.

Thank you.

#

Hello,

Welcome back to icliniq.com.

No, we can not say that this is keratoconus. This is just simple astigmatism. She is just four years old and very young to diagnose any condition. If family members have keratoconus, she might have it in the future. As I said, It is a general rule that the cylinder number will get better with age. She needs to follow up regularly with her eye doctor to treat the conditions in the early stages to avoid lazy eyes. It is better if she avoids rubbing her eyes. If she has any allergy, treat it in the early stages as eye rubbing can increase astigmatism.

Thank you.

Hi doctor,

No one in our family has keratoconus. So it must be simple astigmatism, as both my parents have it. I will try my best to prevent my child from rubbing her eyes.

I hope my child's condition can be treated. How long will it take to bring the vision back to 6 : 6 from 6 / 12?

Thank you.

#

Hi,

Welcome back to icliniq.com.

Yes, it can be treated easily. Probably, with glasses, it will take two months to reach 6 / 6 in both eyes.

Thanks and regards.


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