(Disclaimer: This article is for scientific use only. To protect patient privacy, the information in the following content has been processed. The child was diagnosed with astigmatism in both eyes and amblyopia. Two months later, the child’s naked and corrected visual acuity improved significantly and her astigmatism was corrected. This is a reminder for parents to observe their children’s behavior carefully and be a good guardian and responsible person for their children’s eye health. The parents said the child always blinked repeatedly and squinted when watching cartoons, thinking it was a bad habit. They thought it was a bad habit and told the child several times, but did not pay special attention to it. During the kindergarten physical examination, the child’s visual acuity was found to be substandard, with no previous history of allergies. The common causes of blinking in children were considered to be impingement, bacterial conjunctivitis, allergic conjunctivitis, childhood-type dry eye, and refractive error (including astigmatism), and the child underwent slit lamp examination, which ruled out impingement, no obvious discharge to rule out bacterial infection, no complaints of itchy eyes, and no conjunctival congestion. Visual acuity was OD 0.3, OS 0.25+, and no significant abnormalities were seen in the anterior segment and fundus of both eyes. IOP R12mmHg and L13mmHg were normal and did not meet the diagnostic criteria for dry eye. Subjective optometry: OD+0.75DS/+2.25DC×15=0.3+, OS+1.00DS/+2.50DC×8=0.3+, suggesting the presence of mild hyperopia in both eyes, which was consistent with the age of the 4-year-old child and also belonged to normal, but astigmatism was obvious and its sufficient to affect the child’s visual development and lead to amblyopia. The tear secretion test was 16 mm/5 min (double) and BUT >155 min (double), i.e. both the tear secretion test and tear film rupture time were normal. After the above examination, the preliminary diagnosis was astigmatism and refractive amblyopia. II. Treatment history In order to more accurately understand the refractive status of the child, atropine ciliary muscle paralysis optometry was required, and 1% atropine sulfate ophthalmic gel was given. After 5 days of medication, the optometry was reviewed after ciliary muscle paralysis: OD+1.50DS/+2.50DC×15=0.4, OS+1.75DS/+2.25DC×8=0.4. The diagnosis of astigmatism and amblyopia was determined, and it was clear that astigmatism was the main cause of amblyopia. The corneal topography examination was further improved, suggesting astigmatism of corneal origin, while there was no obvious corneal thinning and posterior surface bulge, basically excluding cone cornea. We gave the prescription OD+2.50DC×15, OS+2.25DC×8, and asked to check wearing glasses, and the child suggested amblyopia training for both eyes at the same time. The child’s family was instructed to review the child in 2 months as an outpatient. The child’s family said that the child likes to wear glasses and is able to adhere to wearing glasses all day long, and the amblyopia training is also very good, 30 minutes per day. Further examination revealed that the eyes were orthotropic; VaSC OD 0.5, OS 0.5; VaCC OD 0.8-, OS 0.8-. Primary optometry OD + 0.50DS/+2.50DC x 15 = 0.8+ and OS +1.00DS/+2.25DC x 8 = 0.8+. The results show that the current treatment effect is very good, the examination of both eyes do not see obvious wear lens, refractive error change is not significant, can continue to wear the original lens, instructed amblyopia training to adjust to every other day once, 2 months later to come back to the clinic to review. We are glad that the astigmatism of the child has been corrected and the visual acuity has been improved significantly. The child should pay attention to maintain good eye habits in daily life, increase time for outdoor activities, maintain correct reading posture and sitting posture when reading and writing homework, and avoid looking directly into the sunlight and staying in an environment with strong sunlight for a long time to reduce eye irritation and fatigue. If the child has amblyopia, wearing glasses is the basis, and he or she must wear glasses all day to improve the refractive state as much as possible. It is also important to insist on amblyopia training in daily life to help the eyes recover their vision. Regular review and timely replacement of glasses are also necessary. Parents should detect visual abnormalities in their children, such as eye rubbing, blinking, squinting, or head-gazing. Fortunately, the astigmatism was detected early and corrected in time, and the child and his family insisted on examination, glasses, training and regular review as required, so that a better result was achieved within 2 months. To correct astigmatism in children, we mainly rely on wearing traditional optical glasses, which are safe and easy to replace, and are suitable for children with fast changing refractive status. For special types of astigmatism (large diopters, axial deviation, etc.), high oxygen permeable rigid corneal contact lenses (RGP) can be worn to better correct astigmatism. Most children with astigmatism can usually be cured with early treatment, while residual astigmatism can be treated in adulthood with keratoconus surgery, or IOL implantation in crystalline eyes.