Essentials of Refractive Exams for Children Children’s visual development is a process from hyperopia to orthopia, but due to the excessive use of electronic devices such as cell phones and iPads by children nowadays, children’s visual development does not stop at the time of orthopia, but further develops into myopia, and the incidence of myopia tends to be at a younger age. Children are more adjustable and it is better for ophthalmologists to use ciliary muscle paralyzing agents such as tropicamide and cyclopentone sulfate to relax eye adjustments during the initial optometry rather than using computerized optometry or insert optometry. Because children are growing and developing, their correction should be combined with eye position. There are many bifocals available today to control myopia development, but whether bifocals have a controlling effect on myopia is highly controversial. In addition, bilinear balance must be performed, and bilinear adjustment must be in a balanced state, not limited to children with clear vision, because children are very adaptable, so the ophthalmologist’s correction cannot be based solely on the subjective symptoms of the child. The refractive development of children is characterized by the development of children, newborns, infants and young children have shorter eye axes and higher refractive power, so infants and young children are basically farsighted in the early stage, but with growth and development, the eye grows, the eye axis becomes longer, the cornea tends to flatten, the lens convexity also gradually becomes smaller, the refractive power also decreases with the development of each anatomical part, and the refractive state tends to be orthoptic. The process of orthokeratology requires a normal visual environment, such as an appropriate distance to see objects. Nowadays, children have fewer outdoor activities, more near-sighted work, and the influence of electronic products in addition to study, thus making the incidence of myopia much higher, especially in urban children. Modern research has found that sunlight is associated with the development of myopia in children, and that the occurrence (or development) of myopia increases accordingly in children with significantly reduced sunlight. Effects of electronics on visual quality and function Visual quality includes two aspects, namely, the imaging quality of monocular vision and the visual function of both eyes. When looking at a distance, no accommodation or assembly is required in both eyes, while when looking at a close distance, in addition to monocular accommodation, an assembly equivalent to accommodation needs to occur in both eyes. Excessive near viewing can lead to visual fatigue in one eye, making the quality of vision in one eye decrease, which is considered to be one of the factors in the development of myopia. In addition, long-term near vision requires long-term binocular pooling, which can easily affect binocular visual function, resulting in visual fatigue, stereo blindness, and in severe cases, strabismus.