If a 4-year-old child has 200 degrees of astigmatism, timely treatment is usually not serious. If it is not treated in time and causes amblyopia, it will be more serious. Astigmatism is a common refractive error, to determine whether a 4-year-old child with 200 degrees of astigmatism is serious, according to the actual situation, can not be generalized. Astigmatism 200 degrees belongs to the moderate astigmatism, if 4-year-old children with astigmatism 200 degrees, can be timely through the standardized treatment, for correction, generally not serious. However, if a 4-year-old child with 200 degrees of astigmatism is not treated in time, it will easily cause amblyopia, and possibly strabismus, which is relatively more serious. It is recommended that the child be actively treated for amblyopia before the age of 8 years old; otherwise, when the visual system matures, it will be difficult to correct the visual defects, which will last for the rest of his life. In conclusion, when a 4-year-old child is found to have astigmatism, he or she should go to the hospital in time, strengthen the management of daily life, and cooperate with the doctor for active treatment if necessary.