Eyeglasses are prescribed for children to improve vision, to prevent and treat amblyopia
and to correct eyes that have become misaligned. Glasses are not required for every
child who is nearsighted or farsighted. Conversely, some children who seem to see
perfectly well without glasses will require full time eyeglass wear to prevent crossing of
the eyes or amblyopia in one eye.
Properly fitting eyeglasses are now available even for newborn infants. Our instruments allow us to determine whether a child requires glasses even when they are too young to read the eye chart. The need for eyeglasses at a young age may run in families. If one or both parents required glasses at an early age, the child is more likely to wear glasses.
Nearsightedness, or myopia, prevents a child from seeing well at a distance. Objects that are near are clear, but distant objects appear blurred. A young child often does not require correction for mild myopia. However, when he/she reaches school age, difficulty reading the blackboard or frequent headaches will herald the need for a first eyeglass prescription.
Farsighted children have the ability to use the focusing power in their eyes to see clearly at almost any distance without correction. Occasionally, farsightedness is severe enough that the eyes become “lazy” and the child elects to leave the world blurred. If this occurs, the eyes do not have the stimulus to develop good vision and if not treated, the vision in later life may be subnormal.
Moderate farsightedness in children is often missed unless their eyes begin to cross. This is called accommodative esotropia. Correction of the farsightedness should begin as soon as crossing is noted and glasses must be worn all waking hours to prevent permanent eye misalignment, or strabismus. If the eyes become permanently misaligned, surgery may be required to straighten them. Bifocals are prescribed when a farsighted child crosses the eyes more for near viewing. The need for bifocals is often outgrown prior to adolescence but their proper wear during early childhood allows for the development of good depth perception (3-D vision) and avoiding a “lazy” eye.
An additional reason for prescribing glasses in children is called anisometropia, a condition where the glass prescription is significantly different between the two eyes. Anisometropia creates a situation where one eye needs to work harder to focus. Often that eye becomes “lazy, or amblyopic, and does not develop good vision. If anisometropic amblyopia is not detected and treated in the early childhood years, the eye may develop abnormal vision. Full time eyeglass wear is required during the first decade of life to prevent amblyopia.
Children who have vision in only one eye should wear protective glasses at all times. A common misconception is that glasses are “dangerous” when a child is roughhousing or playing outside. Actually, appropriate pediatric glasses with sturdy frames and polycarbonate lenses significantly reduce the chance of a serious eye injury.
Pediatric glasses come in attractive styles but it is most important that the glass frames are sturdy, safe and well fitting. If the glasses aren’t comfortable, the child will not wear them. It is important that the optician be experienced in fitting children. Comfortable cable temples curl around the ears and prevent glasses from slipping down the nose. In infants, both cable temples and a strap may be required to keep the glasses in place. Lenses can be made of regular plastic or polycarbonate. Polycarbonate is a strong, shatterproof, lightweight plastic which I recommend for all children’s glasses frames with flexible hinges tend to be more durable and I recommend asking about the availability of a “frame and lens guarantee”. Sports goggles are highly recommended for baseball,basketball, and other sports with a high rate of eye injuries.
Here are a few hints on encouraging a young child to wear glasses. Try not to show your apprehension about the child’s need to wear glasses. If the child is old enough, let him/her pick out the frames. Don't make a game out of putting the glasses on and off. It should be a non-negotiable rule that the glasses stay on. A reward for wearing the glasses and taking care of them is helpful. Also, a good role model can really make a difference. If there is another person wearing glasses that your child admires, take advantage of it and encourage the child to “be like them”. Finally, once the child adjusts, it really does get easier...hang in there. Your child’s eyesight depends on it