Medical History and Physical Exam for Nearsightedness

Topic Overview

During an exam for nearsightedness, your doctor will ask questions about your health, lifestyle, medicines you are taking, and past eye problems. Answers to questions about your family members can help determine whether you may have inherited eye problems.

When a child is too young to be aware of blurred vision (younger than age 7 or 8), the doctor commonly asks the parents questions such as those listed below. The answers may help the doctor know whether the child is nearsighted.

• Is there a family history of nearsightedness? Are the child's parents or siblings nearsighted? (Most nearsightedness is inherited.)
• Was the child born prematurely? (Premature birth is a risk factor for nearsightedness.)
• Where does the child sit in classrooms or movies? (A nearsighted child may have difficulty seeing the board or screen from the back of the room and so may prefer to sit near the front.)
• How far from his or her face does the child hold books to read? [A child with severe nearsightedness will hold books less than 6 in. (15 cm) from the face.]
• Does the child enjoy sports and games? (Nearsightedness makes it harder to enjoy playing sports and games.)
• Does the child squint or frown frequently? (Squinting changes the way light enters the eye and improves vision.)
• How is the child's general health? (A number of diseases may be associated with nearsightedness.)

After about age 8, most children can usually describe the blurred vision caused by the start of nearsightedness, so these questions may not be needed as much.

Physical exam

The doctor inspects the eyelids and other external parts of the eye for signs of disease. Nearsightedness rarely has external signs.

To look for problems with the muscles that control movement of the eyeball, the doctor will ask the person to look in different directions (such as up and down). In a child, severe nearsightedness in one eye can sometimes cause amblyopia (lazy eye).

Jerky movements of the eyes (nystagmus) may be seen in children who have poor vision.