Glasses for Infants and Children


Why are glasses prescribed for children?

Glasses are prescribed for children to help them see better and to prevent and treat amblyopia or eye muscle problems. The vision conditions which may require glasses correction are nearsightedness (myopia), farsightedness (hyperopia), and astigmatism.

How can you tell whether a baby or young child needs glasses?

By using dilating eye drops and a special instrument called a retinoscope, the ophthalmologist is able to determine the focusing power of the eye. The retinoscope shines a beam of light through the child's pupil onto the retina. Lenses of varying powers are then held in front of the eye until the beam is focused on the retina. The focusing power of the eye is thus determined without the need for a response from the child.

How are glasses prescribed?


Your pediatric ophthalmologist will write the power of the lenses needed as a prescription. This prescription is taken to the optical shop and then sent to the laboratory which grinds or manufactures the lenses. The higher the number, the greater the correction in the lens. A plus (+) in front of the number indicates a farsighted or hyperopic prescription ,a minus (-) indicates a nearsighted or myopic prescription.

How to choose a frame

Once you receive the prescription for your child's lenses, the next step is to choose a frame that will be comfortable, safe, sturdy and attractive. Whenever possible purchase the glasses from an optician interested in working with children. Do not hesitate to ask the optician about the quality and expected lifetime of the frame, length of the frame guarantee, and to recommend the most suitable frame style for your child's facial features, age, refractive error and activities.

Infants and young children have relatively flat nasal bridges.

Therefore, glasses will often slide down to the end of the nose. Special attention must be paid to fitting of the nose bridge of the frame. Rolled or flared nose pads are best. Silicone pads with non-skid surface can help the glasses from sliding down the nose. Sometimes rocking nose pads and arms need to be drilled into the nose bridge to obtain a good fit.

Cable temples (comfort cables) are available for frame sizes worn by children one to tour years old. Cable temples secure glasses by curling around the ears rather than pressing on the side of the head. Cable temples often eliminate the need for a strap. Cable temples are usually more comfortable and keep the glasses on better than other types of temples, and are recommended particularly for very active youngsters.

Flexible hinges allow some outward bending of the temple, which is particularly useful in children who often pull the temples outward and away from the head when taking their glasses off. It is not essential to get flexible hinges with cable temples, but the combination does offer the advantage of tolerating more abuse.

Straps may need to be substituted for ear pieces in very young infants. The temples are usually cut short before they reach the ear and have holes in them for elastic straps which go around the back of the head and over the top of the head. This allows the child to lie or roll on the side of his/her head without discomfort or dislodgment of the glasses. The straps may need to be adjusted periodically. Generally an infant's frame will need to be increased in size by the age of 8 to 12 months. At this time cable temples usually can be used instead of straps.

What types of lenses are best?

Lenses are ground according to your ophthalmologist's prescription. Lenses are available in safety glass, plastic, or polycarbonate. Plastic or polycarbonate lenses are lighter and safer but scratch more readily than glass. On the other hand, heavy glasses tend to slide down children's noses and are harder to keep in place.

Scratch resistant coatings can be applied to plastic and polycarbonate lenses but some of these coatings can crack, particularly if the lenses are exposed to heat or cold. Check to see if the coating is guaranteed. Scratches cannot be removed but can be avoided or minimized by appropriate care.

Special Lenses to Reduce Thickness

Some very high power prescriptions cause the lenses to be thick, and special adaptations can be used to provide the best cosmetic and functional fit. The optician should tell you the optimal size of the frame for your child's prescription, and if there are any modifications that can be used to minimize thickness such as tinting, grinding, or beveling the edges. This is an area where an optician's training and experience is very helpful.

Sunglasses, Tints, Photo gray

Tinted lenses for full time wear may be desired by some children or recommended for certain eye conditions. Lenses which darken or lighten as they go from indoors to outdoors or vice versa are available in glass only (Photogrey® or Photobrown®) and are not frequently prescribed for children.

Sunglasses should absorb about 90% of the light and should absorb ultraviolet rays below 470nm. Clip on sunglasses are not generally available in children's frame sizes, but can be specially made by some opticians. Prescription sunglasses can be purchased for children who need to wear their glasses at all times.

When purchasing non-prescription sunglasses for children, care should be taken to assure that the frames meet eye wear standards for flammability, that the lenses are plastic or polycarbonate and (preferably) do not transmit ultraviolet light waves below 470 nm. Ask your doctor and optician about the advantages and disadvantages of tints or sunglasses if your child is very light sensitive.

Safety Glasses

Children who have good vision in only one eye should wear safety glasses for protection at all times, even if they do not need glasses otherwise. Individuals engaged in activities with a relatively high risk for eye injury (including, but not limited to, racket sports, hockey, shop or chemical exposure) should wear safety glasses for those activities. Protective glasses should have 3mm polycarbonate lenses. Frames for safety glasses should be safety approved for industrial use or meet sports safety standards.

Sports Goggles should be ANSI Z 87 approved and pass standards for use in racket sports. Prescription lenses are also available for swimming goggles, ski goggles and scuba diving masks. Your optician can advise you in these areas.

Bifocal Lenses for Children

Bifocals are most often prescribed for young children whose eyes cross with near work. Large bifocals are needed so that the children will use them. If the bifocal is set low, as in adults, the young child will look over and not through them. The prescription may say bifocal to bisect the pupil. Point that out to your optician.

Unlike adults, children rarely have any problem adjusting to bifocals. Progressive bifocals can be used for some children. One drawback is their extra cost. If your optician seems unsure about how to fit a child's bifocal have him or her contact us.

How can I keep the Glasses on my Child?

It is best not to make a big fuss about the glasses. If the child is old enough, let him or her help pick out the frame. Be positive about the glasses and your child's appearance in them. Do follow your optician's advice about proper frame size and fit as these are frequently more important for your child than the appearance of the frame.

If your child is an infant or toddler, try to distract him or her after you put on the glasses. If your child removes the glasses, put them back on. If the child removes the glasses again, put them aside for a while and try again later. Do not get into a tug of war with a very young child.

Take your child back to the optician if you have any questions or concerns about the fit of the glasses. If your child still removes the glasses all the time, call us for further recommendations or directions.

We will tell you how much of the time your child should be wearing the glasses and when and if there are certain activities which could be performed without glasses. Be sure you understand why your child should wear glasses, and what the consequences might be if your child does not wear the glasses.

Care of Glasses

Children should be taught how to remove the glasses properly with both hands so that wear and tear on the temples is decreased. They should be shown how to put them in the glasses case, and be instructed not to put the glasses face down on any surface. Cleaning should be with water, or liquid soap and a soft cloth, not with rough paper towels or tissue.

If the glasses appear to be out of alignment or poorly fitting, take the child and the glasses back to the optician. Tightening of the hinges can often be done at home with a special small screwdriver. Temporarily replacing a missing screw with wires or a paper clip can be dangerous if the wire ends are exposed. Gluing or taping broken frames may also pose a danger, particularly if the glasses are worn for sports activities, and should be avoided if possible.

Our own optical department, the only shop in the area devoted to children's glasses, is the best place to obtain the proper fit, size and weight of glasses for your child.

Glossary

Myopia (nearsightedness)- the light rays entering the eye focus in front of the retina. The term comes from the fact that nearsighted people see better at near than far away without their glasses. Many myopic people can and like to read without their glasses on.

Hyperopia (farsightedness)- the light rays entering the eye focus behind the retina. The term comes from the fact that older farsighted people see better in the distance than at near. It is a misleading term for children since young people are normally somewhat farsighted and have no problem seeing either in the distance or near. As a matter of fact, children have a great capacity to hold things very close and still see clearly. This is due to their accommodation, the ability to change focus that gradually decreases with age. In young people, farsightedness needs to be corrected if the hyperopia is very large and causes decreased vision or if it is associated with crossing of the eyes.

Astigmatism- the light rays entering the eye focus in different planes and not on one point due to the difference in the curvature of the surfaces of the eye or lens. Most astigmatism is due to the cornea (front surface of the eye) not being perfectly round.