Topics:

• Why are glasses prescribed for children?
• Can your baby's eyes be tested for glasses?
• How are glasses prescribed?
• The importance of proper fit
• How to keep the glasses on your child

Why are glasses prescribed for children?

In most cases, glasses are prescribed for children to improve vision, as well as to prevent and treat amblyopia ("lazy eye") or eye muscle problems.  There are also three different types of focusing problems which may require the need for corrective lenses.

These are:

• Myopia ("Nearsightedness")
• Hyperopia ("Farsightedness")
• Astigmatism

Myopia or nearsightedness is inherited and often discovered in children when they are eight to twelve years old.  A myopic eye is longer than normal, causing light rays to focus in front of the retina.  This causes close objects to look clear, but distant objects appear blurred.

Hyperopia or farsightedness is caused by light entering the eye and focusing behind the retina.  A hyperopic eye is shorter than normal.  Older people who are farsighted can see far away objects better than those close at hand.  Most children are normally a little farsighted but have no problems seeing objects up close or at a distance.  Hyperopia needs to be corrected in young people if it causes decreased vision or is associated with crossed eyes.  

Astigmatism occurs when light rays enter the eye and focus at different places on the retina.  It distorts and blurs vision for both near and far objects.  In a normal eye, the cornea (front surface of the eye) is round, like a basketball.  If you have astigmatism, the cornea is shaped more like a football.

Can your baby's eyes be tested for glasses?

Your baby's eyes can be tested even before he or she is able to give a verbal response.  By dilating your baby's pupil, the ophthalmologist can look at the retina using an instrument called a retinoscope.  Lenses of varying power are placed on the front of the eye.  The correct lens or power can then be determined.

How are glasses prescribed?

Your ophthalmologist will write a prescription for your child specifying the necessary lens power.  You then take the prescription to an optical shop where a technician will grind or manufacture the lenses according to the specified power.  A plus (+) in front of the first number means that your child has hyperopia, or is farsighted.  A minus (-) means that your child has myopia, or is nearsighted.  The higher the first number on the prescription, the greater the correction in the lens.

The importance of proper fit.

Because infants and children have relatively flat nasal bridges, glasses can easily slide down a child's nose.  To prevent this, special attention is required when fitting the frames.  There are a number of different devices available to use so that your child's glasses fit properly.

To prevent the frames from slipping, it is best to use rolled or flared nose pads.  Silicone pads with non-skid surfaces are also useful, and sometimes rocking nose pads and arms need to be drilled into the nose bridge of the frames to obtain a good fit.

Cable temples (comfort cables) secure children's glasses by curling around their ears rather than pressing on the sides of their head.  Cable temples are usually recommended for particularly active youngsters and are available for frame sizes worn by children one to four years old.

Flexible hinges allow for some outward bending of the temples, which is particularly useful for a child who pulls the temples away from their head when taking their glasses off.  Flexible hinges are not essential with cable temples, but the combination tolerates more abuse.

Straps may be needed to replace ear pieces in very young infants.  Elastic straps around the back and over the top of your child's head allow them to lie or roll on their side without discomfort or dislodging the glasses.  The straps may need to be adjusted periodically.  Generally, a child's frame will need to be increased in size by the age of 8 to 12 months.  At this time, cable temples are often substituted for the straps.

How to keep the glasses on your child.

Don't make a big fuss about the glasses.  If your child is old enough, let him or her help pick out the frame.  Be sure to follow your optician's advice about proper frame size and fit because these are often more important than the appearance of the frame.  Be positive about the glasses and your child's appearance in them.

Don't  get into a tug of war with your infant.  Try and distract him or her after you put the glasses on.  If your child removes them, put them back on.  If it happens again, set the glasses aside for a while and try again later.

If you have any questions or concerns about the fit; of the glasses, take your child back to the optician.  If your child continues to remove the glasses, call your ophthalmologist for further instructions and directions.

Your ophthalmologist will tell you how often your child should be wearing their glasses and what activities should be done without them.  Be sure that you understand why your children should wear their glasses and what the consequences may be if they are not worn.