King of NY is right on the how. The doctor uses reactions to light and tracking. The prescriptions for babies are not to correct vision in the same way as older kids and adults, but usually to strengthen the ocular nerves in hopes of the child needing less corrective measures later.
My eye doc just explained this the other day. Especially with astigmatism, early corrective measures to strengthen the nerves are vital. If kids go longer to correct it, it less likely to be able to correct it fully, because the nerves don’t develop to focus in the direction of the astigmatism.
And when more in-depth testing is needed….a procedure called retinoscopy is used. As our ophthalmologist described it, it allows her to see exactly how the images appeared to my daughter. She then adjusted the lenses until it was clear. Daughter got glasses at 15 months and it made a tremendous difference for her.
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