Glasses in Children

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What is a refractive error?

There are 4 basic types of refractive errors: myopia (near-sighted), hyperopia (far-sighted), astigmatism (unusual eye shape) and anisometropia (different refractive power of each eye)

1. Myopia is when the distance vision is not clear. This is common in school age children and may be remedied by glasses or allowing the child to be seated closer to the board in school. Myopia is usually an inherited trait, and commonly progresses through the school age years as the eyes continue to grow. There is a direct mathematical relationship between the length of the eye and the degree of near-sightedness . Modifying diet, activity, or frequency of the use of glasses has not been scientifically proven to change the ultimate degree of myopia a child will have.
2. Hyperopia is a little more difficult to understand. Far-sightedness (hyperopia) is the "normal" refractive state for children. Children who have mild to moderate hyperopia are able to see things both far and near, by using the internal focusing mechanism of the eye. When an excessive amount of far-sightedness is present, the child's focusing mechanism may not be able to compensate adequately. If the eye needs to work "very hard" to focus, it may create blurred vision, crossed eyes or eye discomfort. Under these circumstances, glasses may be prescribed to compensate for hyperopia in children.
3. Astigmatism describes a condition where there is an unusual shape of the cornea. Instead of the front of the eye being perfectly spherical, like a tennis ball or basketball, an eye with astigmatism has a different curvature as you rotate the eye. Small amounts of astigmatism do not usually interfere with vision, whereas moderate to severe astigmatism will cause a blurred image at distance and near.
4. Anisometropia is when the refractive power of the two eyes is different. The brain focuses the eyes as a "pair" and cannot focus the eyes independently and simultaneously. What usually happens when there is a difference in the eyes is that the brain “chooses" the eye that is "easiest" to focus, allowing the other eye to be "out of focus". This is very important in early childhood as the brain needs focused images from each eye to develop good vision in both eyes. This can result is amblyopia or "lazy eye" where the brain relies completely on one eye and "suppresses" the other.

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How will I ever get my child to wear glasses?

This is a question commonly asked by parents of infants and toddlers. Most children will recognize that they see better with their glasses and will leave them on. Some children do not accept change easily or object to "things" on their face or head and will resist wearing the glasses. A positive attitude on the part of the parents is extremely important. Starting with a comfortable fitting by an experienced optician is very important. The glasses should fit so that the eye is in the center of the lens. The glasses should not be constantly sliding down the nose, as the child will look over the top of the lenses and defeat the purpose of the glasses. Many trips back to the opticians for adjustments may be necessary. Praising the child for keeping the glasses on, engaging in one on one activities that keep the hands busy and the mind distracted will help at the beginning. If the child is extremely strong-willed and refuses glasses despite all efforts, it is best to discuss other options with your physician. (Sometimes short term drops can be used at home to encourage the child to use the glasses.)

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Does my child need bifocal glasses?

The only valid indications for bifocals in children are if the eyes are crossed or the child has had cataract surgery. Children's eyes can easily adapt in focusing from distance to near without the need for bifocal lenses. Bifocals may also help visually impaired children.