Understanding the Results of a Pediatric Refraction Eye Exam

Once your child has completed a pediatric refraction eye exam, understanding the results is crucial to addressing any vision concerns. You might have scheduled the exam because your child was squinting, reporting headaches, or having trouble seeing things clearly at school, such as the board. Alternatively, a pediatrician might have recommended additional testing following a routine eye screening. Whatever the reason, knowing what the results mean will help you take the next steps in managing your child’s eye health and vision needs. 

While your eye doctor will thoroughly explain the results, having a basic understanding of what they indicate can give you confidence in making informed decisions about your child’s vision care. Read on to learn more about what to expect from your child’s pediatric refraction eye exam results and how to proceed with their vision care moving forward. 

What Happens During Your Child's Refraction Test?

A pediatric refraction test is an essential part of your child’s eye exam. This test measures how clearly your child can see by evaluating how light interacts with the retina, the light-sensitive layer at the back of the eye. The results play a key role in determining whether your child needs glasses or another form of vision correction. Your child’s optometrist may perform a few different types of refraction tests, including: 

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

• Manual Light Reflex Test: In this test, the doctor shines a light into each eye and measures the amount of light reflected from the retina, providing valuable information about your child’s vision quality. 

• Phoropter Test: During this exam, your child will look through a device called a phoropter, which is positioned in front of their eyes. They’ll then focus on an eye chart 20 feet away and identify the smallest row of letters or pictures they can clearly see. 

Because children often focus on nearby objects instead of distant ones, eye dilation is typically used to ensure accurate test results. To facilitate this, optometrists may use cycloplegic refraction, which involves applying eye drops that temporarily relax the focusing muscles of the eye, allowing for a precise measurement of refractive errors and farsightedness. 

How Often Your Child Should Get an Eye Exam

During the first year of your child’s life, they should have an eye exam between 6 and 12 months to ensure their eyes are properly aligned and to screen for conditions such as congenital cataracts, high farsightedness, and early amblyopia. The next recommended exam is between ages 3 and early kindergarten, a critical time for detecting uncorrected refractive errors, binocular vision issues, and amblyopia when treatment is most effective. Once your child starts school and completes a baseline vision exam—designed to confirm clear, comfortable vision for reading and near activities and to establish a pre-school prescription baseline—annual eye exams are advised. These yearly visits help maintain accurate prescriptions during periods of rapid growth, monitor nearsightedness progression, and identify symptoms of computer vision strain. 

Refractive Errors in Young Children

When your eye doctor informs you that your child has 20/20 vision, it means their eyesight is clear and free of refractive errors, signifying that no correction is needed. A “zero” on your child’s chart indicates that their vision is normal and does not require glasses. However, refractive errors are common in children. These errors occur when light entering the eye is not focused correctly on the retina. The most common refractive errors include: 

• Myopia (nearsightedness) makes it hard to see objects in the distance clearly, such as reading the board at school. With myopia, light is focused in front of the retina instead of directly on it. 

• Hyperopia (farsightedness) causes difficulty focusing on nearby objects. In hyperopia, light is focused behind the retina. Some children may experience mild hyperopia early in life, which may correct itself naturally as they grow older. 

• Astigmatism causes blurred vision at both near and far distances. It occurs when the cornea is abnormally shaped, often resembling an oval rather than a round shape. This irregularity in shape causes light to focus at multiple points, preventing 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 Nationwide Vision 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 Receiving Results

Once your child’s exam results are ready, the optometrist will explain the findings in simple terms—what the numbers mean, how they affect both near and distance vision, and whether any immediate action is needed. It’s a good idea to ask for a printed copy of the results or take a photo for your reference, so you can easily share them with teachers, caregivers, or anyone involved in your child’s care. If a refractive error is identified, eyeglasses are typically the first recommendation. Your optometrist will assist you in choosing durable, child-friendly frames and impact-resistant lenses that are ideal for your child’s active lifestyle. 

As your child grows older, they may express interest in trying contact lenses. Daily disposable contacts can be an option for children as young as 8–10 years old, particularly if they’re active in sports or want to boost their self-esteem. Your optometrist will walk you through the different types of contact lenses and help choose the most suitable one for your child’s age, lifestyle, and preferences. 

A follow-up appointment will typically be scheduled within the year to monitor your child’s vision and address any changes in their prescription. These regular check-ups are vital to ensuring your child has the right prescription as they grow, helping them thrive academically, athletically, and socially.