Why do children develop astigmatism?

Generally, children may develop astigmatism due to various reasons such as congenital irregular corneal shape, genetic factors, ptosis (drooping eyelids), keratitis (corneal inflammation), or ocular trauma. It is recommended to seek timely medical attention, identify the underlying cause, and undergo appropriate treatment under a doctor's guidance. A detailed explanation is as follows:

1. Congenital irregular corneal shape: Some children are born with asymmetrical corneal shapes, where the refractive power varies across different meridians. This causes incoming parallel light rays to fail to focus on a single point within the eye, resulting in astigmatism. This is usually regular astigmatism present at birth and remains relatively stable over time. Regular vision checkups are recommended. If the astigmatism is mild and does not affect vision, no special treatment is needed. However, if it affects vision, timely correction with appropriate astigmatism glasses is necessary to prevent amblyopia (lazy eye).

2. Genetic factors: If there is a family history of astigmatism, children may inherit related genes that lead to abnormal development of the cornea or lens, causing astigmatism. It often coexists with myopia (nearsightedness) or hyperopia (farsightedness), and the degree may slightly change as the child grows. Parents should monitor their child's visual habits. If symptoms such as frequent squinting or tilting the head to see objects occur, prompt eye examination is advised. Once diagnosed, corrective glasses should be worn, and regular follow-ups are necessary to adjust the prescription according to ocular development.

3. Ptosis (drooping eyelid): Congenital or acquired ptosis can cause the eyelid to press on the cornea over time, altering its shape and causing astigmatism. This may be accompanied by partial or complete obstruction of the pupil, which can hinder visual development. The more severe the ptosis, the higher the degree of astigmatism. Mild ptosis can be managed with astigmatism-correcting glasses, while severe cases may require surgical correction after medical evaluation. Following surgery, the glasses prescription should be adjusted based on corneal changes.

4. Keratitis: Infections caused by bacteria, viruses, or other pathogens can lead to corneal inflammation. This inflammation may result in corneal edema and scarring, causing uneven refractive power and astigmatism. Symptoms may include redness, pain, photophobia (light sensitivity), and increased eye discharge. During the illness, children should be prevented from rubbing their eyes. Antibiotic or antiviral medications such as tobramycin eye drops, acyclovir eye drops, or erythromycin ointment should be used as directed by a physician to combat infection and promote corneal healing. After the inflammation subsides, appropriate glasses should be prescribed based on the degree of astigmatism.

5. Ocular trauma: Eye injuries such as blunt trauma or scratches can damage the cornea or lens, altering their shape and causing astigmatism. Symptoms may include eye pain and blurred vision, which may appear immediately after injury or during the healing process. Prompt medical attention is necessary after injury to manage the wound. Medications such as recombinant human epidermal growth factor eye drops, sodium hyaluronate eye drops, or cefaclor suspension may be prescribed to promote corneal healing and prevent infection. After recovery, glasses may be prescribed or vision therapy initiated based on the astigmatism condition.

It is important to maintain good ocular hygiene in children. Avoid prolonged near work such as watching mobile phones or television. Every 20 minutes, encourage children to look at a distant object for at least 20 seconds to relieve eye fatigue. Ensure children have sufficient outdoor activity time, at least 2 hours daily, to promote normal eye development and reduce the risk of worsening astigmatism. Regular vision checkups are essential, especially between ages 3 to 6, to detect astigmatism early and correct it promptly to protect visual development.