Children with different visual acuity in both eyes, also known as refractive error, may be caused by physiological factors, or may be caused by imbalance of visual development, hemangioma and other factors. 1. Physiological factors: Mild differences in the refractive states of the two eyes are common, and complete agreement is rare. If the difference is relatively small and other tests are fine, physiologic factors should be considered and observation and follow-up are sufficient. 2. Unbalanced development of both eyes: During the child’s high-speed development, the unbalanced development of vision between the two eyes may lead to refractive error. Generally, it can be corrected by frame glasses. 3. Hemangioma: Certain eyelid hemangiomas can cause refractive error, and surgical treatment can be taken to remove the tumor and then follow up treatment. There are other reasons why children’s vision is different in both eyes, we suggest that they should consult a doctor in time, complete the examination and cooperate with the doctor for active treatment.