CLINICAL

  pediatrics

Eyewear for Children

The essential ingredients for young patients

LEONARD J. PRESS, O.D., F.A.A.O., F.C.O.V.D.

In selecting eyewear for children, specific lens materials, lens types, seg heights and frame characteristics are advisable to ensure successful wear.

Here I discuss these essential ingredients.

Impact-resistant lenses

Polycarbonate and Trivex have become the lens materials of choice for most pediatric lens prescriptions because these materials are impact resistant, making them ideal for young and, therefore, active patients. Also, they both have the advantage of providing 100% UV protection, which parents can appreciate.

Polycarbonate lens materials are available in a wider array of prescriptions and tend to be less expensive than Trivex lenses. Trivex lenses are resistant to warpage and have a higher Abbe value than polycarbonate lenses, providing relatively better peripheral clarity and less chromatic aberration. (See “Other Lens Characteristics,” page 55.)

A flat-top or blended bifocal

For children who have accommodative esotropia, a flat-top 35, flat-top 28 (particularly with smaller frame sizes) or a blended bifocal are optimal choices because you want to reach the maximum plus power as the child looks at near and not at the bottom of the lens. The latter is ideal for when the child’s appearance is a concern of the parent or child. This is because the rounded segment is near invisible and generally comes in a 28mm size.

Little noses can be a big challenge when it comes to frames, so make sure you consider bridge size.

Keep in mind that proper positioning and adjustment of the eyewear on a child’s face is crucial. If the frame keeps slipping down the child’s nose, chances are the multifocal portion of the lens for near isn’t being used.

Ideal seg height

If the seg height is too high on a lined bifocal, the child will find a way to slide the frame down his or her nose to simply look over it. If the seg height is too low, however, the child will look above it. To avoid either situation, subscribe to the Goldilocks philosophy of porridge (neither too hot nor too cold), and generally request the seg height be set to the lower edge of the pupil for a young child who is not yet in school and at least 2mm above the lower lid for a child of school age.

Appropriate bridge sizes

Little children are a big challenge to fit properly with frames because of their little noses. In particular, this can make effectively treating their amblyopia and strabismus with lenses and prisms difficult. To preclude this issue, seek frames that offer appropriate bridge sizes, or frame accessories, such as Stay Puts, from Kids Bright Eyes, which are small silicone attachments designed to keep glasses in the correct position.

Protective eyewear

To ensure optimum vision and safety during athletic activities, sports goggles are a must. These are required to meet the frame and lens standards of the American Society for Testing and Materials (ASTM F803 1) and lens standards of the American National Standards Institute (ANSI Z87.00).

As of late, I’ve noticed that boys, in particular, are wearing their sports goggles for non-sports activities. My point is that these frames are enjoying more widespread acceptance.

Wearability

Let’s face it; a pair of glasses is only as useful as the child’s willingness to wear them. Although it’s generally advisable to select sturdy spring-hinged frames for children, you’ll periodically encounter children who have sensory sensitivities and, thus, do much better with lightweight frames. The benefit with lightweight frames is that if they’re paired with lightweight lenses, the wearer forgets he/she is wearing them, making the spectacles less susceptible to misalignment, damage and/or loss vs. frames that are constantly on and off the face.

In addition to comfort, spectacles must have that “cool” factor to ensure the child, especially the teenager, will wear them. Several companies are aware of this and have designed their child frame lines accordingly. In fact, many frame companies offer “junior” versions of adult styles to enable children to look and feel more grown up. Something else to keep in mind: If children like their frames, they are more likely to take better care of their lenses, which is a big plus for parents.

Happy customers

By keeping in mind these essential ingredients, both the child and his or her parents will be happy with the frame choice, ensuring return visits and referrals. OM

DR. PRESS IS THE OPTOMETRIC DIRECTOR OF THE VISION & LEARNING CENTER IN FAIR LAWN, N.J. HE SPECIALIZES IN PEDIATRIC VISION. HE COMPLETED HIS RESIDENCY PROGRAM IN PEDIATRIC OPTOMETRY AT THE EYE INSTITUTE OF THE PENNSYLVANIA COLLEGE OF OPTOMETRY, AND HE SERVED AS CHIEF OF THE PEDIATRIC UNIT OF THE EYE INSTITUTE. IN ADDITION, HE’S A DIPLOMATE OF THE AAO AND HAS WRITTEN THREE TEXTBOOKS ENCOMPASSING PEDIATRIC OPTOMETRY AND IS A DIPLOMATE IN THE PEDIATRIC OPTOMETRY/BINOCULAR VISION AND PERCEPTION SECTION OF THE AAO. E-MAIL HIM AT VISIONLECTURE@GMAIL.COM, OR VISIT TINYURL.COM/OMCOMMENT TO COMMENT ON THIS ARTICLE.