|Progressive lenses like the
HOYALUX Summit cd work well for kids.
Multifocal lenses can provide relief for children suffering from near vision problems.
The doctor just prescribed multifocals for the child sitting at your dispensing table and the parents are confused. After all, parents identify multifocals with seniors, not with childhood. So why do some kids need near help?
NEED FOR NEAR
During accommodation, three things take place: the eyes converge, the pupils constrict, and the crystalline lens increases its curvature and thickness which creates additional plus power. This is the accommodative triad.
The fly in the ointment here is that the eyes converge. When a child is diagnosed with an “eso” (a turning in) problem as he views near objects, the eyes will converge more than needed. This can become a pattern that defines a child’s evolving visual pathways and reinforces the inward turn. For some kids with accommodative insuffiency, accommodative spasm, or strabismus, the need for accommodative relief comes into play.
“Accommodative spasm” with long-term near viewing (like video games or computers) means they will not be able to return to distance focus easily, as they are temporarily “frozen” in the accommodative state. With too much plus power, they are kind of stuck for a while. Kids will complain about distance vision, but it’s actually the near vision that has to be addressed. By introducing plus power for near vision, the accommodative need is reduced. The corrective lens will take the plus power needs out of the equation and the accommodative needs can just relax.
Easing near vision fills the bill in most cases. Eyecare professionals who have done this for decades have bought into the old axiom “fit’em with execs and fit’em high.” Those days are long gone. The executive bifocal is the thickest multifocal option offered and when combined with small kids’ frames, it can be a cosmetic nightmare. Instead, think about flat top 28s, flat top 35s, and progressive addition lenses (PALs). Flat tops provide a thinner profile, and for more cosmetically appealing eyeglasses, go with the PAL. Ultra-short corridor PALs work great for kids. Fit them at mid-pupil, the same way a conventional bifocal for kids is fitted.
WHAT TO USE?
Kids need safe lenses (polycarbonate or Trivex® lens material) and can also benefit from anti-reflective (AR) treatment and photochromics—after all, their “work” is in school (with fluorescent lighting) and outside playing (with UV light).
Virtually all labs can supply flat tops in polycarbonate or Trivex lens material and most are available in photochromic options. When it comes to PAL lenses, look to ultra-short corridor versions. Options include: Shamir Insight, Inc.’s Autograph II®; Younger Optics’ Adage; Carl Zeiss Vision Inc.’s SOLA Compact® Ultra and Zeiss GT2™ Short; HOYA VISION CARE, North America’s HOYALUX® Summit cd™; Seiko Optical Products of America, Inc.’s Supercede WS and Surmount lenses; and Essilor of America, Inc.’s Varilux® Ellipse®, Varilux Physio Short™, Varilux Physio Short DRx™, new Varilux Comfort DRx Short™, and new Varilux Comfort Short™.
While it may seem odd to parents, kids sometimes need multifocals. Proper ophthalmic treatment and good optical help are the keys to helping these children improve their vision.
Sharon Leonard is a licensed optician and contact lens practitioner in the Syracuse, NY, area.
WHERE TO FIND IT
Carl Zeiss Vision Inc.
800-358-8258 • zeiss.com/lenses
Essilor of America, Inc.
800-542-5668 • essilorusa.com
HOYA VISION CARE, North America
877-528-1939 • hoyavision.com
Seiko Optical Products of America, Inc.
800-235-5367 • seikoeyewear.com
Shamir Insight, Inc.
877-514-8330 • shamirlens.com
800-366-5367 • youngeroptics.com