Could children benefit from a low plus near reading prescription?

In my experience, most children younger than age 12 are visually asymptomatic and, therefore, don’t receive glasses. They tend to have low degrees of hyperopia, with boundless amounts of accommodation. For that reason, it’s rare to prescribe for these hyperopic patients, unless they are really struggling with reading and in their schoolwork. However, the parent is frequently unaware of how the child performs in the classroom, and the child’s version of their vision history is often vague. Most of these kids seem to do well without corrective lenses. But don’t you sometimes wonder whether they could benefit from a low plus near reading prescription? Certainly, parents don’t want to buy glasses that are unnecessary, but if glasses helped the child achieve greater success in school, the parents would be motivated to provide that. Here’s how we solved this problem in our practice.

CREATE AN INVENTORY OF LOW PLUS READERS

We offer the asymptomatic, low hyperopic child an opportunity to try low plus readers in a trial program that is risk-free to the parent. We made eight pairs of +0.25 D low add digital enhanced single vision lenses in various boys and girls frames with different sizes. This polycarbonate lens offers a +0.40 ADD power, has an AR coating and blocks high-energy blue violet light and UV radiation.

QUANTIFY SYMPTOMS

We created a symptom questionnaire similar to the SPEED questionnaire that is used for dry eye disease testing. (See document, above.) The parent and child take the survey to assess the degree of symptoms and discomfort and then choose a trial pair of glasses. We charge their credit card for the full price of the trial glasses when they leave, telling parents that the charge will be fully credited back to them when the trial is complete.

MEASURE SUBJECTIVE IMPROVEMENTS

Two weeks later, the child and parents return for follow-up. They complete the questionnaire a second time to see whether there are any subjective improvements in visual functioning. If not, the glasses are returned to our inventory of trial glasses. If there is subjective improvement, however, they can select any frame they want, and we give them the exact prescription that the patient needs instead of the +.25 that the trial glasses are made in.

SEE THE BENEFITS IN PRACTICE

The parents love this risk-free way of sampling glasses in order to discover whether low plus glasses would help their children perform better in school. Roughly half of the children who have taken advantage of this program have benefitted from the new glasses. This also represents a group that we had previously not prescribed for, thereby, also increasing the practice’s optical business. OM

DR. ZIEGLER is the senior partner at Ziegler Leffingwell Eyecare in Milwaukee, WI, now part of MyEyeDr, and is a fellow of the American Academy of Optometry. Email him at daveaziegler@gmail.com.