An eye that has no refractive error when viewing distant objects is said to have emmetropia or be emmetropic meaning the eye is in a state in which it can focus parallel rays of light (light from distant objects) on the retina, without using any accommodation. A distant object in this case is defined as an object located beyond 6 meters, or 20 feet, from the eye, since the light from those objects arrives as essentially parallel rays when considering the limitations of human perception.

An eye that has refractive error when viewing distant objects is said to have ametropia or be ametropic. This eye cannot focus parallel rays of light (light from distant objects) on the retina, or needs accommodation to do so.

The word "ametropia" can be used interchangeably with "refractive error". Types of ametropia include myopia, hyperopia and astigmatism. They are frequently categorized as spherical errors and cylindrical errors:

• Spherical errors occur when the optical power of the eye is either too large or too small to focus light on the retina. People with refractive error frequently have blurry vision.

  Nearsightedness: When the optics are too powerful for the length of the eyeball one has myopia or nearsightedness. This can arise from a cornea or crystalline lens with too much curvature (refractive myopia) or an eyeball that is too long (axial myopia). Myopia can be corrected with a concave lens, which causes the divergence of light rays before they reach the cornea.

  Farsightedness: When the optics are too weak for the length of the eyeball, one has hyperopia or farsightedness. This can arise from a cornea or crystalline lens with not enough curvature (refractive hyperopia) or an eyeball that is too short (axial hyperopia). This can be corrected with convex lenses, which cause light rays to converge prior to hitting the cornea.

  Presbyopia: When the flexibility of the lens declines, typically due to age. The individual would experience difficulty in near vision, often relieved by reading glasses, bifocal, or progressive lenses.

• Cylindrical errors cause astigmatism, when the optical power of the eye is too powerful or too weak across one meridian, such as if the corneal curvature tends towards a cylindrical shape. The angle between that meridian and the horizontal is known as the axis of the cylinder.

  Astigmatism: A person with astigmatic refractive error sees lines of a particular orientation less clearly than lines at right angles to them. This defect can be corrected by refracting light more in one meridian than the other. Cylindrical lenses serve this purpose.

• Genetics

  There is evidence to suggest genetic predilection for refractive error. Individuals that have parents with certain refractive errors are more likely to have similar refractive errors.

  

  The Online Mendelian Inheritance in Man (OMIM) database has listed 261 genetic disorders in which myopia is one of the symptoms. Myopia may be present in heritable connective tissue disorders such as: Knobloch syndrome (OMIM 267750); Marfan syndrome (OMIM 154700); and Stickler syndrome (type 1, OMIM 108300; type 2, OMIM 604841). Myopia has also been reported in X-linked disorders caused by mutations in loci involved in retinal photoreceptor function (NYX, RP2, MYP1) such as: autosomal recessive congenital stationary night blindness (CSNB; OMIM 310500); retinitis pigmentosa 2 (RP2; OMIM 312600); Bornholm eye disease (OMIM 310460). Many genes that have been associated with refractive error are clustered into common biological networks involved in connective tissue growth and extracellular matrix organization. Although a large number of chromosomal localisations have been associated with myopia (MYP1-MYP17), few specific genes have been identified.

• Environmental

  In studies of the genetic predisposition of refractive error, there is a correlation between environmental factors and the risk of developing myopia. Myopia has been observed in individuals with visually intensive occupations. Reading has also been found to be a predictor of myopia in children. It has been reported that children with myopia spent significantly more time reading than non-myopic children who spent more time playing outdoors. Socioeconomic status and higher levels of education have also been reported to be a risk factor for myopia.

Blurry vision may result from any number of conditions not necessarily related to refractive errors. The diagnosis of a refractive error is usually confirmed by an eye care professional during an eye examination using a large number of lenses of different optical powers, and often a retinoscope (a procedure entitled retinoscopy) to measure objectively in which the patient views a distant spot while the clinician changes the lenses held before the patient's eye and watches the pattern of reflection of a small light shone on the eye. Following that "objective refraction" the clinician typically shows the patient lenses of progressively higher or weaker powers in a process known as subjective refraction. Cycloplegic agents are frequently used to more accurately determine the amount of refractive error, particularly in children

An automated refractor is an instrument that is sometimes used in place of retinoscopy to objectively estimate a person's refractive error. Shack–Hartmann wavefront sensor and its inverse can also be used to characterize eye aberrations in a higher level of resolution and accuracy.

Vision defects caused by refractive error can be distinguished from other problems using a pinhole occluder, which will improve vision only in the case of refractive error.

How refractive errors are treated or managed depends upon the amount and severity of the condition. Those who possess mild amounts of refractive error may elect to leave the condition uncorrected, particularly if the patient is asymptomatic. For those who are symptomatic, glasses, contact lenses, refractive surgery, or a combination of the three are typically used.

Strategies being studied to slow worsening include adjusting working conditions, increasing the time children spend outdoors, and special types of contact lenses. In children special contact lenses appear to slow worsening of nearsightedness.

A number of questionnaires exist to determine quality of life impact of refractive errors and their correction.

The number of people globally with refractive errors that have not been corrected was estimated at 660 million (10 per 100 people) in 2013.

The number of people globally with significant refractive errors has been estimated at one to two billion. Rates vary between regions of the world with about 25% of Europeans and 80% of Asians affected. Near-sightedness is one of the most prevalent disorders of the eye. Rates among adults are between 15-49% while rates among children are between 1.2-42%. Far-sightedness more commonly affects young children, whose eyes have yet to grow to their full length, and the elderly, who have lost the ability to compensate with their accommodation system. Presbyopia affects most people over the age of 35, and nearly 100% of people by the ages of 55-65. Uncorrected refractive error is responsible for visual impairment and disability for many people worldwide. It is one of the most common causes of vision loss along with cataracts, macular degeneration, and vitamin A deficiency.