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Refractive Errors

Robert M. Kershner, MD, MS, FACS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Refraction is the bending of a wave of light as it passes from air through the more dense optical system of the eye. The degree of bending is dependent on the index of refraction thr...

DIAGNOSIS

HISTORY

  • Difficulty seeing objects at a distance

  • Difficulty focusing on near objects or reading

  • Headaches (from squinting)

  • In children:

    • Sitting close to TV/computer screen

    • Declining grades

    • Prefere...

TREATMENT

GENERAL MEASURES

  • Spectacle lenses (glasses)

  • Soft/hard contact lenses

  • Surgery

MEDICATION

Precaution: Antimuscarinic agents may induce acute glaucoma via acute-angle closure in susceptible individu...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Exams recommended when starting school, entering college, with any change in vision quality, and at the age of onset of presbyopia (the need for...

REFERENCES

1
Kershner RM. Keratolenticuloplasty. In: Gills JP, Martin RG, Thornton SP, et al, eds. Surgical Treatment of Astigmatism. Thorofare, NJ: SLACK; 1994:143–155. [View Abstract on OvidMedline]
2
...

ADDITIONAL READING

  • American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus. Vision Screening for Infants and Children—2013. ...

CODES

ICD10

  • H52.7 Unspecified disorder of refraction

  • H52.00 Hypermetropia, unspecified eye

  • H52.10 Myopia, unspecified eye

  • H52.4 Presbyopia

  • H52.202 Unspecified astigmatism, left eye

  • H52.6 Other disorders of ...

CLINICAL PEARLS

  • Vision screening should occur at each well-child visit.

  • Visual acuity testing should be performed at 3 to 5 years of age or at any time that the physician or parent is concerned about t...

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