With so many frame companies and retail businesses focusing on the ever-popular Millennial generation, it may be easy to forget that children, beginning in infancy and continuing to age 18, represent a critical patient group. The 3-month-old baby you begin seeing could become a customer for many years! The Journal of Pediatrics estimates that 5% of preschool children have a vision deficiency that is correctible with eyeglasses. As they get older, the count goes up to approximately 20%. VCPN spoke with three practitioners who have focused on kids in three distinct age groups.

The littlest patients often present some of the biggest fitting challenges. In many cases, the most 
severe problems with newborns are discovered in the delivery room or within the first three months. Danielle Crull, optician and owner of A Child’s Eyes, in Mechanicsburg, PA, said that her first rule of thumb is to be prepared with eye-catching gizmos to start the exam.

“The optician’s tool belt [should have]toys, bubbles, animals and anything you can think of to get a child’s attention,” Crull said. She actually invented her own type of PD ruler with windows that can be placed in front of each eye. “I can hold it in front of an infant, usually held over the parent’s shoulder in the burping position, and get a fast and fairly accurate PD.”

Pediatric opticians also need to be highly inquisitive because non-verbal children can’t express what’s bothering them. Crull will have babies or toddlers wear their glasses around the office for a while, then remove them and look for marks on their nose or ears. Then she will readjust accordingly. “The goal is to have even pressure points across the nose, on the sides of the head and no marks behind the ears. By the time they leave, the glasses fit perfectly,” Crull explained. “I also pay special attention to areas they may be poking at.”

Another common issue that arises with this population is asymmetry of the head, and the various adjustments that may require changing the temples to have unequal lengths, adding cable adapters and/or changing the nosepads.

Crull thinks fitting children has become easier on a lot of levels with newer eyewear meant to fill these specific needs. Some of her favorite lines include Dilli Dalli from ClearVision Optical Co. for flexibility and adjustments behind the ears, Specs4Us specifically suited for the needs of the Down’s Syndrome child, TC Charton for the unique needs of the Asian population, and Tomato Glasses for infants and toddlers for quick and easy modifications of the nosebridge and temples. “I also keep a wardrobe of colorful eye patches for kids undergoing amblyopia therapy,” she said. “It’s the best experience to put glasses on a 2 year old and have their eyes light up when they look at you!”

Nearly every state mandates an eye exam or screening before a child enters a pre-K program or kindergarten. That is often the first time a parent is made aware of a vision problem. As kids progress through elementary school, they should be screened or examined periodically. When their bodies grow, their eyes do, too. At The Glasses Menagerie in Minneapolis, MN, Julia Chous, a pediatric optician, has a waiting area that welcomes little ones. “The first thing kids notice when they come into the office is a large aquarium. We also have a fun movie playing.”

When it comes to frame selection, Chous said she tries to make it as fun as possible. “We talk directly to the child, and we ask about their favorite colors. The whole try-on period is like a game of dress-up for the kids. The optician has veto power if it’s a ‘no’ based on how they fit. It is important to visualize the lenses in the frames and consider their weight as well. ” She then takes monocular measurements manually.

She adheres to some key factors when it’s time to stock the dispensary. “When buying frames we keep in mind that they should not be just mini versions of adult frames. Children often have broader bridges and need shorter temples.”

Qualities she looks for are color selection, spring hinges, customizable temples, durability and a good warranty. Frame lines she likes include OP by ClearVision Optical, Lafont and Matisse.

When the glasses are delivered, she has special instructions for kids and parents: “Always use two hands when putting on or taking off the glasses. Our opticians all wear glasses, so they can demonstrate this. Also, we tell them that their glasses were made only for them to help their eyes to see. If a friend or sibling asks to try them on, this is the one time when it’s okay not to share. We also have them repeat this rhyme: ‘On your face, or in the case, never any other place.’”

From middle school onward, most kids can wear adult-sized frames and are able to fully cooperate in the measuring process. Their facial features are just about fully developed, and they don’t need to up-size as often. Larry Riolo, LDO, of Davis Optical in Rome, NY, has a special affinity for these age groups.

“I’ve known many of the tweens and teens who come here since they were really small. I watched them grow, and they are comfortable working with me. They understand directions and follow them, so I normally use a pupillometer.” Riolo continued, “Regarding fitting, they usually can tell me exactly where the discomfort is. I also look for pressure points that may be potential comfort issues. Items that frequently require attention are nosepads and temples.”

Larry Riolo favors frames with spring hinges and points out that fast-growing teenagers need plenty of adjustments. “Sometimes teens will come into the office complaining about red marks on their nose, and I discover that the nosepad is either missing or broken!” He adds that many of his patients are athletes and he makes sure that he can meet those needs as well. “If they are ordering sports-specific eyewear, I like them to bring in any headgear needed so we can look for protective eyewear that is compatible,” he said.

One of his new popular lines is Converse from DeRigo REM. “A decade or so ago I would have considered this line primarily for the guys. Now it’s one of my go-to lines for girls,” Riolo expressed. “The colors, styling and durability features are all appealing to teens as well as their parents.”

Sharon Leonard, LDO, ABOC-AC, FCLSA, is a licensed optician and contact lens practitioner in the Syracuse, NY, area.


WHERE TO FIND IT: Clear Vision Optical 800.645.3733 • CVOptical.comCService@CVOptical.com // DeRigo/REM 818.504.3950 • CustomerService@DeRigo.us // Lafont 800.832.8233 • Lafont.com // Matisse Eyewear 212.288.5827 • MatisseEyewear.Shutterfly.comSam@NewLightEyewear.com // Specs4US 800.586.1885 • info@specs4us.com // TC Charton 855.707.0220 • TC-Charton.comInfo@TC-Charton.com


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