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Guidelines for Prescribing Glasses in Children

Condition Refractive Errors
Age < 1 year Age 1-2 Years Age 2-3 years
Isoametropia
Myopia ≥ -5.00 ≥ -4.00 ≥ -3.00
Hyperopia (no strabismus) ☆ ≥ +6.00 ≥ +5.00 ≥ +4.50
Hyperopia with esotropia ★ ≥ +2.50 ≥ +2.00 ≥ +1.50
Astigmatism ≥ 3.00 ≥ 2.50 ≥ 2.00
Anisometropia without strabismus ♠
Myopia ≥ -4.00 ≥ -3.00 ≥ -3.00
Hyperopia ≥ +2.50 ≥ +2.00 ≥ +1.50
Astigmatism ≥ 2.50 ≥ 2.00 ≥ 2.00
Oblique Astigmatism ♦ ≥ 1.00

☆ may under-correct by +1.00 to +3.00
★ give full plus
♠ Threshold for correction of anisometropia should be lower if the child has strabismus
♦ Defined as >15 degrees from 90 or 180 meridian

  • These values are based on consensus of expert opinion
  • For children 4 years and older: prescriptions should be based on visual acuity measurements and visual functioning when at all possible
  • Adapted from AAO Preferred Practice Pattern 2012, Pediatric Eye Evaluations p. 19 PDF from AAO Website