A child with 4.5 to 4.6 vision does not necessarily need glasses, and the final decision on refractive corrective treatment needs to be made based on the child’s age, fundus disease status, and refractive system response. Children’s visual acuity levels vary with their environment as they develop. Typically, vision is around 4.6 at age 4, 4.9 at age 5, and a normal 5.0 by the time they enter elementary school. Some children may have delayed development of visual function, and their visual acuity may be slightly lower than that of children of the same age, but the refractive error is normal, and the child’s visual acuity will return to the normal level as he or she grows older, so a child with visual acuity of 4.5 to 4.6 does not necessarily need to get glasses. 4.5 to 4.6 is a visual acuity value and does not correspond to a refractive error, which should be measured through a detailed optometry examination, which will give a prescription for glasses. If the patient is a preschooler with immature vision, the refractive error may lead to poor visual development and the formation of amblyopia. The best time to treat amblyopia is before school age, so the prescription should be corrected in time. For children with visual acuity between 4.5 and 4.6, it is recommended to go to the ophthalmology department for a detailed examination to determine whether glasses are needed. It is recommended to strengthen the protection of the eyes in daily life, avoid excessive use of the eyes, and consult a doctor in time for treatment if there is any discomfort.