20/40 Vision - Are Glasses a Necessity When You're 4?

Updated on November 30, 2012
C. asks from McKinney, TX
16 answers

I recently took our 4 year old daughter to have her vision tested as part of the regular wellness program recommended by her pediatrician, and was VERY surprised when her results were 20/40 - astigmatism. I like our opthamologist, who explained that IF she were able to take a driving test, she wouldn't pass with that kind of vision, but my husband and I are wondering what this really means for our four year old. Her birthday is in mid-September, so she won't start kindergarten until 2010. She is learning to read. She certainly notices all the rabbits in our yard! We're just not sure if her vision is poor enough to warrant the pressure of wearing glasses. Any advice out there?? And one more thing - frames! Our doctor's optician whipped out Disney frames with all the bling which completely abrades my husband. There was one pair that scored "almost acceptable" with me, but I'm hoping we can find something more suitable. I remember an old photo of my cousin from 1960something wearing huge, white, cat-eye frames with rhinestones and I don't want to do that to my child -ha,ha! Thanks in advance for your input.

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So What Happened?

My daughter doesn't need glasses afterall. I took her for a second opinion from a PEDIATRIC Opthomologist (who knew? Guess there's a doc for everything!), Dr. Alan Davis, at Plano Presby. He came highly recommeded, and I can see why - WONDERFUL! He said that she has a very, very mild astigmatism, but nothing more that warrants glasses. He also said that 20/40 was within normal range for a 4 year old, that vision is a rather bell-shaped curve in that babies are very near-sighted and that vision for distance progresses throughout childhood. For a 20 year old with more stable vision, glasses would be recommended for 20/40 vision, but at 4 years old her vision is changing and her life is within 20 feet of her for the most part anyway. We're scheduled to take her back in a year. I'm sure she'll eventually need glasses as both my husband and I have worn them (I had Lasik and love it!), but for now she'll get to remain free of that pressure for a while longer. One more thing - He said to be cautious of offices that also sell frames. Whereas they may be fine doctors, they also bear the financial burden of having to move inventory, so you're more likely to walk out with a set of glasses. For him, he found it to be a conflict of interest. Lastly, THANK YOU for your responses! I can tell that there are some compassionate, loving, "sisters-in-motherhood" out there. God bless you all.

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answers from Dallas on

It is up to you, but as a child whose parents didn't feel it was necessary until later, like 7th grade, later, the lack of vision manifested in poor grades (how could I do my homework which was written on the board if I can't see the board), behavioral problems stemming from frustration with my inability to follow along to a teacher who I couldn't see, etc. All of those problems could have been solved by the wearing of corrective lenses, no matter what the stigma. As a child, my vision progressed to get worse and worse to where when I finally got glasses, I saw leaves on the trees for the first time since I could remember. By that time, I had 20/300, 20/400 vision. If you want to wait, well, remember that she is observing the world and learning every day. Don't you want her to actually see the world?

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answers from Dallas on

Your child sounds like my now 8yr old daughter. She has been wearing glasses since she has been 5 (right before kindergarten) but knew she needed glasses WAY before then. The reason why she did not wear glasses earlier was my fault and not able to find a pediatric opthamoligist..I have a great one now. Needless to say, my recommendation is to put her in glasses now. My doctor warned me her vision could change and the glasses could help improve her vision. We were on a 6 month visitation schedule and did see her vision change. One day, my daughter stated she could not see and we got her into the Dr within days of her comment and had to change her perscription. She was in kindergarten and was learning key critical concepts and I could not stand knowing she could not see.

Another benefit to her wearing the glasses now is learning responsibility and just getting used to wearing them. My daughter is great at keeping up with her glasses, partially because she does not like what she sees without glasses:)

My daughter was one of the first wearing glasses. By mid 1st grade, I want to say at least 1/3 of the class was wearing glasses!

Your daughter is 4 and is either beginning read or reading already. The glasses will help with this process so I say go for them now.

I am 47 and not wearing glasses YET..but my husband does so he is in charge of glasses purchases. We have purchased glasses from Lens Crafters and we always get the stuff that makes the glasses turn dark in the sun. My daughter loves the pink or purple tint..pay extra and get done because it is worth it.

I hope this helps. Feel free to reach out if you have questions.



answers from Dallas on

Dear C.:

Except for the astigmatism, that's my daughter's vision. My daughter is 13 and entering 8th grade next year. She has glasses that she only wears for seeing the white board in the classroom and at the movie theater.

I have astigmatism myself, and that CAN cause eye strain, particularly with reading.

What I would do in your position is probably hold off on glasses and reassess after starting school. Let the teacher know so he/she can let you know if she's seeing eye strain or trouble reading the board.

When you do have to go with glasses, less bling and STURDY frames with a good case area a must! At that age glasses spend less time being worn and more time being lost or sat on!

L. F., mom of a 13-year-old daughter



answers from Pittsburgh on

REGULAR vision for a child from 48 months (4th birthday) to 59 months is 20/40. visual acuity develops with age and should be fully developed by age 6. at 5th birthday it should be aprox 20/30 and some even get as specific as 20/32. But you see where this is going. I do not recommend going crazy about her vision but definitely keep up with regular screenings and compare results from one to the next to track a problem or progress. I was alarmed also when my daughter 49 months old was tested at 20/40 since I did not have the greatest vision but I was reassured by her pediatrician, child development screener, and eye doctor that was perfectly normal and on track for her age. I also learned boys vision develops slightly faster so if you have a son you may not get that shocker!!!! :) Take care and don't stress it. Just have her checked at or around each birthday.



answers from Dallas on

Our daughter started wearing them last Fall and she just turned 4 in May. I was very shocked and had mommy guilt because I've been blessed to not have to wear them and my husband just started wearing his 2 years ago and we are late 30's. I didn't really think she needed them either until we got them and watched her look at things like she'd never seen them before when they have always been there. One example is that we took her to her favorite restaurant to "celebrate" the glasses and we could barely get her to eat because she just kept looking around. I'm not sure about your daughter's condition but mine is only temporary thankfully and the glasses are being used to correct the problem. However, if we had not gotten them, she could have developed learning difficulties and her eyes would get worse to the point of being irreversible. Although you see that your daughter sees things, she may not see them clearly and thinks that's normal because she doesn't know any other way. We got my daughter's glasses at McKinney Optical. They are princess but they are the Ariel ones which are thin frames and are a dark purple. Good luck with your decision.



answers from Topeka on

You 100% right to do what you did. I had the exact experience to a tee, Disney frames and all. My daughter is 4 turning 5 in 2 weeks. Reads has great up close vision, does not squint at distance, and has 20/40 in her right eye just like I did. Her left eye has little to no prescription. I got my first pair of glasses when I was in 7-8th grade. I did not get poor grades. I told my Mom the board was getting a little blurry and we got glasses. I had the same prescription in 1st grade. Got to love genetic's :-) My Dad is a physician and I work in the medical industry. You where smart to go to a MD. for a second opinion. Good for you! All I have to say is a parent i.e Mother knows her child best.



answers from Dallas on

If your daughter has astigmatism then her vision at distance and near may be affected. Children under the age of 6 need good visual stimulus to develop normal correctable vision. Nearsighted children with 20/40 distance vision have 20/20 near vision so the child has some good visual stimulus (most of a 4 year old's world is in their hands). If your daughter never has 20/20 vision (near or far) which would be true with astigmatism, then she may develop amblyopia. Amblyopia may make it more difficult for her vision to be fully corrected in the future. The visual system is still developing through the age of 6. Therefore it's important to address these issues before the age of 6 to ensure healthy visual development. If the blingy frames are the big issue you can visit nearly any retail optical and get some more ordinary kid friendly frames. Hope this helps good luck to you.



answers from Dallas on

My son started wearing glasses shortly after he turned one. I didn't even know they could wear glasses that young! I was like you and was somewhat heartbroken when I learned that he was going to have to wear glasses, just because I know how mean children can be when they get a little older. My son is now four years old and his glasses are just like another part of his body. We don't really think about them any more. As far as other kids are concerned, right now they could care less that he wears glasses. They really don't even pay any attention to the glasses. That may change as he gets older, but I am just hoping that we are instilling enough self-confidence in our son that it won't matter. Also, when our son gets old enough, and when he asks for them, we can always switch to contacts, then it won't even be an issue.
As for the hideous children frames, I completely know where you are coming from. There are some scary ones out there. We have found that Dallas Youth Optical (www.dallasyouthoptical.com) tends to have the best selection of children's frames around. They have a big selection of frames that are not neon pink or blue, or have cartoon characters on them. My son has a really "handsome" pair of glasses that my husband said he would wear if they came in his size. :o) They also have a really good warranty program. As you can imagine with little kids, we had a pair of glasses completely destroyed. They replaced the frames completely for free.
Good luck on your eye glasses adventure! I know you'll make the best decision for your family. Just wanted to share my experience with our son.



answers from Dallas on

With all due respect to your ophthalmologist, 20/40 is acceptable vision for a 4 year old. I'm not sure, but perhaps the lenses are recommended because of the astigmatism. PLEASE do a LOT of research---get a second opinion and read everything you can get your hands on. Don't just put lenses on your daughter because one fellow said so.



answers from Dallas on

Both my daughters have been wearing glasses for about a year - one is 6 and the other is 4. The advantage to starting now is that she will be used to the glasses "rules" (don't touch them unless going to sleep, they are not toys, etc.) when she starts school, and at that point they will just be a part of her. As far as the expense, Wal-mart has glasses for about $50 for both frames and lenses. And they warranty the work. They also offer specials in the fall when it is time to go to school. We bought the pretty glasses from the opt, but bought everyday glasses from walmart!



answers from Dallas on

Get those glasses for that baby girl. If she is seeing 20/40 she should be squinting to look at things. Probably not all the time but I bet she does.

Your eye chart goes 20/20 is the AVERAGE

Then you have 20/25, 20/30, 20/40

There are still 3 lines under the 20/20 line that some people can see.

So she is seeing 7 lines up from being the best vision of all and 3 lines up from see 20/20.

I hope that makes you look at it a different way.

You dont have to purchase the frames with your doctor you can take your prescription any where.

Good luck with everything!



answers from Dallas on

I had my eye glass reduced twice because my vision was improving, my Dr. very surprised in a good way. I have have been taking nutritional supplement among many things improved my vision. They have safe product for children that you can give your daughter that may help improve her vision as well. Let me know if you are interested.

I am a mom of 2, married and work from home, always looking for other moms who need extra income working from home.



answers from Dallas on

I can understand your hesitancy--it will likely be a challenge to get a 4-year-old to wear, rather than play with, glasses--but as someone who has been in her shoes, I would say that you should get them for her. My parents waited until I was 7, at which point I was legally blind (20/200): hopefully your daughter will never get this bad. BUT, it's definitely worth the expense and inconvenience to have her see well. It took me YEARS to catch up on things like sports and coordination (I'm still not the best)--I HATED playing outside with other kids when I was 5/6 years old, because things like tag and ball were harder for me than for other kids, since I couldn't see as well (I know that now--at the time, I just thought I was bad at playing!). And it really is a whole new world when you can see clearly--I still remember my wonder at seeing individual leaves on trees, instead of just a green blob where I knew leaves were. As you point out, I'd definitely find a place that will give you simple, functional, and inexpensive frames for a kid that small--I, personally, don't think there's much (if any) need for "bling" on a 4-year-old, whether on her glasses or elsewhere! GL!



answers from Dallas on

As a parent who has been there, done that, I suggest you make an appointment with a pediatric opthamologist for a second opinion. The pediatric opthamologist will have equipment specifically for children that will enable him/her to make a more accurate diagnosis. If the pediatric doctor recommends glasses, then do it. I agree with Riquel to get your daughter used to the glasses before school if it is decided she needs them. My son wore glasses from 4 years until 6th grade, stopped, and is now looking at wearing them again for reading in college.


answers from Dallas on

If a Dr. told me that my child needed glasses....I would not wait. Health and Safety are issues we do not mess with and make no exceptions.

If you are still against getting glasses for her, go get a 2nd opinion and see what another Dr. says.

We spare no expense ro ensure good health of our child. I understand the "bling" factor......find something suitable and get here eyes right. Who's to say what might be going on that you don't know about and it could possibly be corrected if treated this early.



answers from Dallas on

Hi C.,

Please get the glasses for your daughter, I have that same vision and didn't realize how bad I was seeing until I got my glasses. And the longer you wait to correct her vision the worse it will get. I am 28 and didn't start wearing glasses until I was 23 and I wish I would've started wearing them before, but I didn't realize I needed glasses until I went to get my Texas drivers license and I failed the vision test. It's amazing what the world looks like when it's not mixing like a water color painting :-)

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