You cannot judge whether a patient is nearsighted based on a visual acuity of 4.6 alone. Astigmatism, farsightedness, cataracts, etc. can all affect a patient’s vision, so you can go to the hospital or a professional organization to have a relevant examination to clarify whether the patient is nearsighted or not. The standard of visual acuity is different for different age groups. For example, a child of one or two years old with a visual acuity of 4.6 belongs to the normal visual acuity range. Children over the age of five with a visual acuity of 4.6 are relatively low, and cannot be determined to be due to myopia, but may also be due to astigmatism, farsightedness, lens clouding and other reasons, and need to be examined by a professional dilated pupil optometry to determine whether it is nearsightedness. Therefore, if a child aged 1 to 2 years old has a visual acuity of 4.6, this is within the normal range of vision and there is no need to be overly anxious. If a child over 5 years old has a 4.6 visual acuity, it may be due to a variety of reasons, not necessarily due to myopia. It is recommended that patients with vision loss seek medical attention to evaluate their condition and follow the doctor’s instructions for treatment.