10 Things to Know About Your Child and Glasses
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Your child’s vision should be checked early
At about 6 months of age, children should be taken to an optometrist for the first complete vision examination. The doctor will not only test the child’s vision but also will examine the eye’s overall health and check for movement ability and alignment.
InfantSEE ® managed by Optometry Cares ®—The AOA Foundation is the American Optometric Association’s public health program designed to ensure that eye and vision care becomes an integral part of infant wellness care to improve a child’s quality of life. Under this program, participating doctors of optometry provide a comprehensive infant eye assessment between 6 and 12 months of age as a no-cost public service. Visit the InfantSEE website to learn more and locate a doctor in your area who can provide a free infant assessment.
We recommend Eyediology as an InfantSEE provider.
Discuss the appropriate intervals for future eye examinations with your child’s doctor. The American Optometric Association recommends the following intervals for examinations:
| Patient age (years) | Asymptomatic/low risk | At-risk |
| Birth through 2 | At 6 to 12 months of age | At 6 to 12 months of age or as recommended |
| 3 through 5 | At least once between 3 and 5 years of age | At least once between 3 and 5 years of age or as recommended |
| 6 through 17 | Before first grade and annually thereafter | Before first grade and annually, or as recommended thereafter |
Know the signs of vision trouble
The American Public Health Association estimates 10 percent of preschoolers have eye or vision problems. Preschool-age children don’t often complain about their eyes so parents should watch for signs that may indicate vision problems.
Signs of vision trouble include:
Sitting close to the TV or holding a book close
Squinting
Tilting the head
Covering one eye
Frequently rubbing their eyes
Short attention span based on developmental age
Eyes turning in or out
Sensitivity to light
Difficulty with hand-eye coordination
Avoiding coloring, puzzles or other visually-detailed activities
If your child displays any of these symptoms find an optometrist for an exam. You can ask friends for their favorite doctor of optometry or find a local provider from the American Optometric Association.
My family has had great experiences with the following local offices:
Eyediology
Yesnick Vision
Center for Sight
My child was tested at school
Child care centers and local schools often provide vision screenings for your children, this may also be offered by your pediatrician. A vision screening is not the same as a comprehensive eye exam.
A comprehensive eye exam may include some or all of the following tests. Your exact experience will depend on your provider.
Visual acuity measurements evaluate how clearly each eye is seeing. Reading charts are often used to measure visual acuity. As part of the testing, you will read letters on charts at a distance and near. This is where we get the numbers like 20/20 when referring to vision.
Keratometry measures the curvature of the cornea. This exam is most important for those wearing contacts.
Refraction determines the power of the lens in your glasses needed to correct refractive errors like nearsightedness, farsightedness, and/or astigmatism. The optomitrist will use an phoropter to place a series of different lenses in front of your eyes and then measure how these lens focus light using a retinoscope. Eye drops may be used for this test.
Focusing, teaming and movement tests are conducted to see how effectively your eyes change focus, move and work in unison to see a single, clear image. This is where the doctor will find issues on focusing or your eyes not working together properly.
Eye health is assessed using dilating drops to widen the pupil so the doctor can the structures inside the eye. Your optometrist will also measure the pressure inside the eye as part of the complete health check of this organ.
Should I see an ophthalmologist or an optometrist
Optometrist
An optometrist attends optometry school for four years and then may do one extra year of residency. Optometrists will have an OD after their name, signifying a doctor of optometry degree has been earned. An optometrist is normally who you would schedule an appointment with for routine comprehensive eye exams. If an optometrist feels your eyes need more attention than they can provide, they can refer you to an ophthalmologist.
Ophthalmologist
An ophthalmologist goes to medical school for four years, followed by four years of residency and often a one or two year fellowship to specialize. Ophthalmologists may have a specialty, like pediatrics, and will have an MD, a doctor of medicine or a DO, doctor of osteopathic medicine. An ophthalmologist is also a surgeon and can treat diseases of the eye.
Optician
Last but certainly not least, we should recognize the other professional responsible for helping in the process of correcting vision, the optician. An optician helps you select and fit your prescription eyeglasses and explain various lens types and coatings that are appropriate for your lifestyle and your prescription. the optician works with the orders written by either an optometrist or an ophthalmologist.
It’s more than just 20/20
There are four basic types of refractive errors:
Myopia
Myopia is nearsightedness, meaning distance vision is blurred. A prescription for myopia would be indicated be a negative sign in front of the number (for example -2.00). Children with myopia may do better sitting closer to the front of the classroom.
Hyperopia
Hyperopia is far-sighted vision. It’s perfectly normal for young children to be far-sighted as their eyes are developing. A child who is farsighted may not need correction unless it is excessive or causing problems such as blurred vision, eye crossing or the child complains. Hyperopia prescriptions are indicated with a + sign in front of the number (for example +7.50).
My son Sam is farsighted and got glasses for the first time when he was 3 years old. His exam when he was a year old was fine so we didn’t expect him to need glasses. While we didn’t really notice the signs until after his exam, the difference after corrective lenses was apparent. Sam’s prescription is a +7.50 like the example above and he wears his glasses full time.
Astigmatism
When the eye is shaped with a larger curve in one axis than another, that’s an astigmatism. Think basketball versus football, a football is an eye with the astigmatism.
Anisometropia
Anisometropia is when the eyes have different refractive powers, often causing focus issues. Anisometropia is the most common cause of amblyopia, which is commonly called lazy eye. This is often fixed with eye drops or eye patching.
Did you know that even if your child isn’t showing signs they could have a vision deficit? Often vision deficits manifest as an attention or behavioral problem, but really the child could be experiencing something like focusing issues or a lazy eye. Vision therapy is physical therapy that uses lenses, prisms and filters to help improve the child’s visual skills. Find a local developmental optometrist at www.COVD.org.
Sizing Up Frames
Don’t commit to glasses just because that’s all your optometrist’s offices has, take the time to look at other local shops and online before making your decision.
The best tip I ever got when Sam was given glasses was to join the Facebook group For Little Eyes. This collective group of parents is amazingly supportive and helpful when trying to find the best frames for your little one. Join For Little Eyes.
The most important things to check when fitting your child’s frame:
Be Centered: Eyes should be centered in the lens for a correct fit. Children are often sized improperly for glasses making them less than effective at vision correction. If the optician you are working with doesn’t understand how to fit your child properly, you can choose another shop. Always advocate for your kids and yourself.
Bridge the Gap: Make certain that there is no gap between the bridge of the nose and the bridge of the frame. Gaps in the fit will cause the frames to slide hindering the benefit of the glasses and the child’s desire to wear them.
This post from Discount Glasses has more information on sizing for your child.
Frames come in different materials and style and you want to choose one that fits your child and they will wear comfortably.
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