|A young boy stopped breaking his ‘baby glasses’ because they had cable temples when they were switched to skull temples (ClearVision’s Dilli Dalli Munchkin shown here).|
|Tween girls love color in their frames and an 11-year-old started wearing her glasses when she got the color she wanted (i-dealoptics’ Peace Eyewear Uptown style shown here).|
|Active kids require sun as well as sport protection and the Bollé Piranha Jr. Rxable sunglass offers both.|
|THE NOSE KNOWS Many small kids have little or no bridge and fitting them with the proper lenses to keep the weight off their noses can be a challenge. For those young patients wearing particularly strong plus prescriptions, make sure that you or your lab uses the smallest lens blank possible and aspheric or digitally produced lenses to ensure the thinnest profile. In addition, avoid too much decentration of the lenses as this can cause a thick edge nasally that can result in discomfort on their noses.|
|Photochromic lenses are a good choice for children who spend a lot of time outdoors.|
While children can present unique issues, there are inevitably solutions to each one. Here are some examples.
Dispensing eyewear to any age group requires good technical knowledge and hands-on skills. When you’re working with kids, however, you have to employ other skills that you don’t usually need with adults-like psychology. That’s because children don’t behave like adults. Kids have definite feelings about eyewear styling and color, and they can become easily upset or embarrassed when things don’t go their way. When something goes wrong with a pair of eyeglasses that was dispensed to a child, you have to approach the troubleshooting process a little differently than you would with an adult.
THINK LIKE A CHILD
Troubleshooting eyewear problems with kids means you have to think like a child. Look for the obvious problems first, which is what you would do if you were working with an adult. If you don’t discover it, put yourself in the kid’s place: Why might I not want to wear these eyeglasses? If I don’t want to wear these eyeglasses, what can I do to either get my parents to let me stop wearing them or bring me back to the optician so I can get a different pair? Working with children can make you one heck of a detective and the investigation sometimes leads to some pretty interesting situations. Read about the following challenges and see if you can guess the solutions.
Problem: The parents of an active young boy who has been wearing eyeglasses since he was 1 because of strasbismus bought him polycarbonate lenses and a frame with cable temples from a practice that has an unlimited warranty on breakage for one year. About every two to four weeks, the mother brought him in with yet another breakage. Although she didn’t have to pay for the repairs, she became increasingly more frustrated that she had to come in so often.
On one particular visit, the exasperated mother was almost abusive to a staff member in the dispensary. After observing the encounter, I asked to speak to the little boy. I asked about his likes and dislikes and his opinion of eyeglasses. He liked specific brands but didn’t like “baby” eyeglasses. His definition was that because the temples wrapped around his ears like when he was a baby, they were baby eyeglasses. He was intentionally breaking them because he didn’t want to look like a baby.
Solution: We switched the cable temples to skull temples using the same brand. The mother initially didn’t think it would work, but two weeks later came in to thank us for discovering the “problem.”
Problem: A boy in third grade got his first pair of eyewear for full-time wear. One of his visual symptoms was headaches. Even though the boy spent a lot of time outdoors, the parents did not want to invest in two pairs of eyeglasses. The optician therefore recommended polycarbonate lenses for durability. He was still complaining of headaches a few weeks later so his parents brought him back to the doctor. Two things were discovered during this visit: The boy was photophobic and needed sun protection, and his parents were concerned that he would lose or break his clear eyeglasses while outdoors so they instructed him to leave them inside at school when he went out to play.
Solution: The lenses were switched from clear to photochromic lenses, and both the child and parents were educated about the importance of wearing the eyeglasses all the time for visual and physical protection.
Problem: A single pair of eyeglasses was purchased for a 10-year-old boy because that was what his insurance covered. Within the first few months, he came back twice with a broken frame. We talked to him and discovered that he plays tennis using his indoor pair since he needs them to see. Fortunately, he suffered no injury.
Solution: A single pair of eyeglasses is not going to meet all of this patient’s visual lifestyle needs. Dispensers need to let parents know that while vision coverage offers a huge savings benefit, it won’t pay for everything, and if a child has multiple needs, they need multiple pairs. This tween requires sun protection as well as sport protection. There are so many cool looks in sun protection today that his needs are easily met.
Problem: An 11-year-old girl needs eyeglasses. She loves a purple acetate frame that the optician shows her but her mother wants her to have a pair that is neutral so that it matches everything. They purchase a tan frame because it matches her skin tone. She comes back two weeks later complaining of not being able to see clearly. After a re-exam, no change is found in the prescription. The optician talks to the girl and finds out she is embarrassed to wear the eyeglasses she doesn’t like. She loves lots of colors and dislikes tan.
Solution: The optician discusses the emotional needs of kids with the parent. It can be a balancing act, but ultimately the parent understands that if the child doesn’t like the eyeglasses and doesn’t wear them when she is away from the parent, her vision would be affected. The change is made to a frame the girl loves and has color in it. Interestingly enough, she is happy and sees better.
Problem: A 16-year-old girl with a very narrow bridge receives a metal frame with adjustable nosepads. The eyeglasses continued to slip so the optician switched the pads to soft silicone pads to eliminate the slippage. The situation seemed better, until about two weeks later, when the teen came back with very sore red marks on her nose. She thought the eyeglasses may be too tight.
Solution: A licensed optician determined after a close examinations that the eyeglasses were adjusted well. What she determined was that the teen had a severe sensitivity to silicone nosepads. The optician switched to vinyl nosepads and ensured that the adjustment was spot on and the problem was solved.
Many teens use medications that make their skin more sensitive. Be sure you discuss sensitivities and eliminate known sensitive materials such as silver/nickel or silicone from your recommendations.
Problem: A 15-year-old boy receives eyeglasses for the first time for myopia because he had been experiencing headaches and eyestrain. A month later, the parents brought the boy in because he was still still experiencing headaches and eyestrain.
Solution: After questioning the patient, the optician discovered that the boy was fine with his eyeglasses and that his accommodation is working well too. However, he spends an exhorbitant amount of time on his smartphone, tablet, and laptop. The optician identified digital eyestrain and recommended appropriate lenses/treatments. In addition, the patient and his parents are educated about digital eyestrain and the need for the patient to wear his eyeglasses to protect his vision.
Troubleshooting kids’ eyewear issues can really challenge your dispensing and investigative skills. Even so, it’s worth all the effort!
Diane F. Drake is a licensed optician, writer, lecturer, and consultant to optical professionals in Jackson, GA.