The incidence of astigmatism in the population is high. Mild astigmatism does not pose an impact on visual development and vision can be corrected by wearing glasses in adulthood, however, more pronounced astigmatism can have an impact on visual development and without timely treatment, amblyopia can last a lifetime. Parents are often unable to distinguish whether their child’s astigmatism is severe, whether it needs to be treated, or what the implications of treatment are. The vast majority of parents, even, cannot say what astigmatism is. So I’ve summarized these common parent questions below. What is astigmatism? In layman’s terms, astigmatism is when the eye is not round. If the eye is shaped like a soccer, there is no astigmatism; conversely, if it is shaped like a rugby ball, there is astigmatism. Some astigmatism is the result of the cornea being out of round, and some is the result of other parts of the eye not being round. Is astigmatism congenital? By definition, astigmatism is a developmental abnormality and is naturally a congenital condition. It is less likely that the eye is round when it is young, but less round as it grows older, and even if it changes, it will not change significantly. Parents often ask, “Can our child’s astigmatism be cured? Since astigmatism is congenital, it is unlikely that the original less round eye will grow more and more round as it develops. Therefore, the majority of children with astigmatism do not change their astigmatism over the years. For the few that do, there is no significant change. There is no way to treat an eye that is not round and make it absolutely round. If you have laser treatment as an adult, it will only cut the shape of the cornea to compensate for the other parts of the eye that are not round. Therefore, training and massage will not change the shape of the eye, and naturally have no special effect on astigmatism. Of course, there is no need to purposely change the shape of the eye, because the eye itself does not have any organic structural problems. What are the dangers of astigmatism? Since astigmatism is not an organic problem and the eye is not round, what are the risks? Yes, because the eye is not round, any external objects are blurred when they are imaged on the patient’s retina, in other words, the image is not clear enough. This blurred image stimulates the development of a blurred visual cortex on one side of the brain, and this delayed development of the visual cortex is called amblyopia. This delayed development of the visual cortex is called amblyopia, which is characterized by poor vision with glasses. How to treat astigmatism? Since we know the harm of astigmatism, the most important treatment is to wear the right glasses. After wearing the glasses, any external object, through the lens, becomes a clear image when re-imaged to the patient’s retina. This clear image will stimulate the development of the visual cortex on one side of the brain. Obviously, there is a time limit for the development of the visual cortex of the brain, generally from birth to about 7-8 years old, which we call the plastic period. In other words, after adulthood, no matter how much the visual cortex is stimulated with clear images, the brain will not develop anymore, because it has already developed definitively. Therefore, the younger the age, the better the treatment effect for amblyopia caused by astigmatism. Some parents in Asia (including our country, India, Japan, etc.) do not want their children to wear glasses at an early age, so it is easy to miss the best time to treat these patients. Do I have to wear glasses for astigmatism? No. Astigmatism varies in magnitude and axis, and has different effects on the clarity of the retinal image. In other words, in mild astigmatism, the retinal image clarity is not affected much, and the corrected vision can reach the normal standard of the corresponding age, so it is not necessary to wear glasses; on the contrary, in severe astigmatism, resulting in blurred retinal image, it is necessary to give clear retinal image as early as possible. Therefore, to wear glasses or not to wear glasses, it is necessary to analyze the patient’s symptoms, age, and various factors, depending on the degree of astigmatism, axial direction, corrected visual acuity, and various factors. A pediatric ophthalmologist is a doctor who specializes in this field. What is the difference between astigmatism and myopia? Can I wear glasses a few years later, like myopia? According to what was mentioned above, we can know that the retinal object image is always blurred in astigmatic eyes. And myopia and astigmatism are completely different. In a myopic child, the image of something at a distance is blurred to his retina, while the image of something at a certain distance (depending on the degree of myopia) is clear to his retina. Therefore, in these children, the visual cortex has the opportunity to receive clear image stimulation and development is generally unaffected. We rarely refer to myopia as amblyopia unless it is a high degree of congenital myopia, where the visual cortex is not stimulated enough by clear images and there is a part of amblyopia, and early glasses will improve the vision. Therefore, the need for glasses for severe astigmatism is far more urgent than for myopia. Parents should also not take the experience of myopia and apply it to astigmatism. Of course, even with myopia, wearing glasses later in life may have an effect on the regulatory collecting system, which is a different topic. If our child has astigmatism, will he or she have to wear glasses for the rest of his or her life? Can’t we cure it even if we wear mirrors? Astigmatism can be treated with excimer laser treatment in adulthood, but in childhood, glasses are the mainstay of correction. Wearing glasses does not eliminate astigmatism, but provides clear images to the retina and stimulates the development of the visual cortex in the brain. This process of visual cortex development is a process that humans must go through after birth. The brain’s visual cortex can only develop normally if it is stimulated with clear images in a timely manner during the plastic stage of development.