Pediatric dispensing for any age

Key Points

Unless your practice is in a retirement area, there's a good likelihood that you will have children visiting your office. From babies to toddlers to pre-teens, there are many important considerations to implement when you are dispensing to kids.

Birth to 3 years of age

On average, a child's visual acuity doesn't reach 20/20 until age 3. A variety of conditions and diseases are what will bring the fearful parent and child in, such as congenital cataracts and glaucoma, strabismus, eye and/or skin growths, or amblyopia. Many times contact lenses are the correction of choice; however, if eyewear is necessary, there are many important items about which to educate the parent.

4 to 9 years of age

This age group is a lot of fun to work with. They still listen to adults, yet have strong feelings for their eyewear. They are likely to select bright, colorful frames, probably associated with cartoon characters or girl/boy brands. While they still allow their parents to take charge, it's important to talk to them at their level. Sit on the floor, kneel down or sit in a low chair while showing frames. The same lens considerations remain here: UV protection and impact-resistant lenses (polycarbonate or Trivex).

10 to 12 years of age

This age group is known as tweens, and they are growing up faster than ever before. They do not want to be referred to as children. They are greatly influenced by the Internet, TV, and music. While they tolerate their parents, the sales presentation should be to the child. They will be very interested in brand names associated with fashion and/or sports.

Special kids

Many kids with special needs will require eyewear. Try to accommodate their disabilities without much fanfare. They may be in a wheelchair, be unable to talk, cry/laugh uncontrollably, or be autistic. If they don't function well with strangers, try to schedule them early or late, because they can be disruptive. Talk to the kids unless there is a severe disability, because most children like the communication. The reward of a smile or clapping hands can be priceless.

Frame considerations

Because a baby, toddler, or child's face is a work in progress, selecting and fitting the frame is crucial. One key area to look for is a well-fitting bridge for their developing nose structure.

Another important criterion is to select a frame size whose eye size and bridge are close in size to the pupillary distance (PD) of the child. Measuring the PD of a little one can be tricky, especially if their eyes are dark and you are unable to distinguish center of pupil. In this instance, measure from the temporal edge of one iris to the nasal edge of the other iris.

When fitting temples, the temple itself should not touch the sides of the ear until just before the ear. Unless the temple style is a comfort cable or riding bow, the bend should occur at a 30º to 45º angle, beginning at the top of the ear and conforming to the bone process behind the ear. Look for bridges and temple tips to have soft, non-slip materials to provide comfort and keep eyeglasses in place. Eyewear retaining cords are a great idea for active little ones.

Lens tips

From birth to adult, children need impact-resistant lenses. The only ophthalmic materials that meet this demand are polycarbonate and Trivex. Fortunately, these materials provide 100% UV protection as well. Consider photochromic lenses (Transitions) to reduce glare and offer comfort while outdoors. Besides, kids really like the "cool factor" of lenses that lighten and darken automatically. Remember, if they like their glasses, they are more likely to wear them!

Sports eyewear

When children reach the age of joining sports teams such as T-ball and soccer clubs, it's time to recommend the American Society for Testing and Materials (ASTM)-approved sports eyeguards. Contact lenses and/or everyday eyewear and sunwear do not provide protection from flying balls, pokes from fingers or sticks, or physical impact from another person or the ground. ASTM-approved eyeguards undergo testing that includes balls flying more than 90 mph at a variety of angles; the eyeguard and lenses must not break and lenses must remain in the eyeguard. ASTM F803 is probably the most important style to carry, because it covers the common sports such as soccer, women's lacrosse, basketball, and baseball. There are other ASTM styles designed for paintball, skiing, and hockey, to name a few. Carry a variety of ASTM-approved eyeguards in a wide range of sizes to meet the needs of your active pediatric patients.

Lens care

I have learned if you want it-teach it. Make no assumptions when it comes to taking care of eyewear, especially with little ones. Take the time to demonstrate proper-care techniques (to both the parents and the child). Use a cute rhyme such as: when the glasses aren't on your face, they live in their case. Show them how to set eyewear down temporarily-not on the lenses. Demonstrate the proper method for folding the eyewear and inserting properly into the case. Show them how to put on and take off their eyewear on their heads-with two hands! Instruct them to rinse lenses prior to spraying or rubbing the lenses, to assist in preventing lens scratches. Giving a cute case and lens cleaning cloth will help to encourage proper care.

A couple comments on closing notes with your pediatric patients. Do not say: "If you have any problems, stop in." If you say that, there will be problems.

Rather, tell them that if they ever have any questions, please call or stop in. Invite the parents to bring their child in regularly for adjustments and inspection of eyewear. Tell them that well-maintained eyewear fits better, is more comfortable, and provides for ultimate visual ability.