22
The Path to
Perfect Vision
WORDS: Dr. Paige Laudicina, Eye Center, Inc
Much like the fact that we are not born with the innate ability to recite our ABCs
and 123s, we are not born with innately perfect vision, either. It’s a process for
the visual system to develop, one that typically occurs through a series of events
and along an average time-line. In this article I thought I’d discuss that average timeline,
and when monitoring imperfections, versus intervening with glasses or other treatments,
In our infancy (birth to 18 months) there is a great deal of self-regulating of the visual system
occurring, with the ultimate goal of low hyperopia (far-sightedness) by approximately 12
to 18 months. (1) This process of clear vision gradually developing over time is referred
to as emmetropization.
clear image, our eyes grow in length in order to help create the clearest image, using the
error throughout childhood. (Other factors include the curvature of the cornea and the
thickness of the ocular lens).
process was successful, one should have a low amount of hyperopia. If emmetropization
has not occurred properly, this is the time where it could be appropriate to intervene by
more than +3.50D, there is a moderate amount of astigmatism, and/or there is a large
Prescribing glasses in these cases may be necessary to prevent visual discomfort and/or
amblyopia. More simply, I personally try to avoid prescribing glasses at this age, unless I
have reason to believe that not prescribing may be detrimental to a child’s vision, long term.
to see an increased incidence of myopia (near-sightedness) and myopic progression.
Myopia is the most frequent cause of correctable vision impairment worldwide, and by
the year 2050, many studies indicate there will be nearly one billion myopes.
The inheritance pattern of myopia is multifactorial and complicated, but a child’s risk of
becoming myopic is increased if he or she has myopic parents and/or siblings. Also, as
a general rule, the younger a child is when found to be myopic, the more myopic they will
likely become. Children who are diagnosed before the age of 7 seem to have the highest
risk of progression. (3)
child’s prescription gets worse from one year to the next. I understand the concern,
and according to the child and the situation, we may discuss how this is a normal part
of development and nothing to fear, or we may discuss potential methods of reducing
myopia progression.
Something to consider in terms of myopic progression, is that as a child ages, the risk of