A fifteen-year-old girl sat in my chair recently for her very first eye test. She’d never complained about her vision. Her schoolwork was fine, she read on her phone like every other teenager, and nobody at home had noticed anything at all. She was there mainly because she’d never had one.
Her left eye came back at -4.75. Her right was -1.00.
Her mum went quiet when I read those numbers out, and then asked the question I hear from almost every parent in that spot. How did we not know?
The honest answer is that there was very little to notice. Short-sightedness blurs things in the distance but leaves close vision perfectly clear, so a phone or a book looks sharp to a short-sighted teenager. That’s where kids spend most of their day. On top of that, her right eye only needed a small correction. With both eyes open, her brain simply leaned on the better eye and got on with things. The board at school was probably a little soft, but soft is easy to live with when you’ve never seen it any sharper. Kids don’t compare their vision to anyone else’s. They assume everyone sees the way they do.
That’s exactly why I’d never wait for a child to complain.
Optometry Australia recommends a full eye exam before a child starts school, then every two years after that if everything is fine. Here in NSW, most kids also get a free vision screen at four through the StEPS program at preschool or day care, and it’s a genuinely good program. But a screen at four can’t pick up a problem that hasn’t started yet. Short-sightedness usually shows up later, often during primary school, and it can keep climbing for years. A child who passed every check at four can be well into the minus numbers by their early teens without saying a word about it.
Once the numbers are on the table, dwelling on the past doesn’t help anyone, and I told her mum as much. What matters now is the next few years. A fifteen-year-old’s eyes are often still growing, and while that growth usually slows through the later teens, it doesn’t stop on a set date. At -4.75 her left eye is already highly myopic for her age, and a longer eyeball carries a higher risk of retinal problems later in life. Any growth we can hold back now is worth having.
Ordinary glasses will sharpen her vision, but they do nothing to slow that growth. Myopia control can. So rather than handing over a prescription and sending them on their way, I booked her in for our full myopia control consultation. At that appointment we measure the axial length of each eye, which is the physical length of the eyeball, and with this much difference between her two eyes I’ll be tracking each one on its own. From there we can talk properly about what suits a teenager’s life, whether that’s a specialised spectacle lens like MiyoSmart or overnight ortho-k. Some options handle a big gap between the eyes better than others, and that’s part of what we’ll work through together.
If you’re reading this and quietly thinking about your own kids, you’re far from the only one. Plenty of families we see in Hurstville have never booked an eye test, simply because nothing ever seemed wrong. That isn’t anyone’s failing. It’s just how this kind of problem hides.
If your child has never had a full eye exam, or it’s been more than two years, it’s worth booking one even if they swear they can see fine. Book online or call us on 02 8021 2298, and we’ll take a proper look.
Some details in this story have been changed to protect our patient’s privacy.