Children who need glasses, need glasses that fit.
Unfortunately, we see more than a few young children in the facebook group with glasses that are completely inappropriately sized for them.Megan’s son Mason (pictured above) is 10 months old. She took him to an optical shop and was told that the glasses he’s wearing were a perfect fit and the smallest glasses available. Both are not true. Those glasses are far too large for little Mason. They are way too far down his nose and his eyes are not at all centered in the lenses (you can read more about how to know if glasses fit well here).
She went back to the shop and the good news that a different optician there helped her to find smaller frames that fit him better, but it required multiple trips to a shop that was an hour away, and she would not have had to make those trips at all had the optician fit her son with the correct size to begin with. We should be able to rely on professionals at optical shops to help us find good-fitting glasses for our children.After reading about Megan’s story, I wanted to talk to a children’s optician about what parents can do to make sure they find optical shops that will do a good job fitting their child and what to do if you end up with glasses that don’t fit.
An interview with an optician about finding good glasses that fit your child
Danielle Crull is an American Board of Opticianry Master-Certified Optician. She specializes in fitting of infants through teens at her optical shop, A Child’s Eyes. She’s done guest posts with us in the past about children’s glasses in general as well as answering a question about fitting children with flat nasal bridges.
Little Four Eyes: Thank you so much for joining us, Danielle. Can you start by reminding us about why fit is so important for children?
Danielle: A good fit is important for several reasons. Firstly, a good fit will provide the best vision. When the glasses slide down, they effectively increase the prescription in a plus lens and effectively decrease the prescription in a minus lens. This may not be too much of a big deal in lower prescriptions, but in a higher prescription it can make a significant difference. So if they do not fit well, your child may not be looking through a properly powered lens. Secondly, good fit=comfort! If the glasses do not fit well in any way, either slipping down or too tight, your child will be less likely to want to wear them. Eventually, he or she will associate their glasses with discomfort or with a feeling of annoyance. Thirdly, if your child overcomes the discomfort or the annoyance, they will simply develop a bad habit of wearing the glasses down on his nose. This, of course, leads to not looking through the center of the prescription and as mentioned before changes in the effective power of the lens. Habits are so hard to break. Sometimes it takes years for me to get a child to actually wear his or hers glasses properly once they have developed bad habits from a poor fitting.
L4E: What should a parent look for in an optical shop? Are there things to look for on their website or questions to ask on the phone that would let a parent know that the shop will be able to accommodate and fit a young child?
Danielle: Absolutely, you should ask around, and ask questions of the optician. I think the real telltale sign of experience with children is the selection they offer. If you go into an optical shop and they have only a few frames or want to order from a catalog, just turn around and walk out. No child can be properly fit from a catalog! Ask about size availability on a frame. Most frames will come in several sizes, make sure they are actually measuring and fitting your child. Some places just want to get rid of that toddler frame that’s been sitting on their frame board for two years. So they are motivated to tell you they fit just fine. There is nothing wrong with asking them to order the smaller size in and then bringing your child back to try them on before committing to having the lenses cut and put into them.
If you’re calling on the phone, don’t ask how many children’s frames they have. Ask them how many toddler, infant or preschooler frames they have. If the practice doesn’t fit many young children, they may say they have a 100 frames but that would include frames fitting everything from a 5 year old to a teenager. Ask about the education of the opticians. Some states require licenses and others have no requirements. If you’re in a state with no requirements then find out if the optician or opticians have a National Certification through the American Board of Opticianry. When you bring your child to the doctor you assume they have met some sort of educational requirement, often they display their license on the wall. Unfortunately, you cannot assume the same from an optician. Opticians are regulated on a state by state basis. Ask if they have a toy area. I know this may seem insignificant, but it will definitely tell you how many little ones come in their office.
Fitting children is not the same as fitting an adult. Children are measured differently, frames often need modified to fit children, even bifocals sit differently. Children have unique medical issues which require special fitting and children require special lenses that hold up to the impact resistance of a child’s activity. So finding a place that knows your child’s unique needs is very important. Glasses for a young child often require a lot of maintenance…your child’s optician should be able to give you expert advice, cheerfully repair and adjust as needed. Consider your optician another key person in helping your child develop healthy vision, they are not just a salesperson (well, at least they are not supposed to be). The doctor can prescribe any prescription he or she wants to, but if your child will not wear it because it doesn’t fit well, your child will not succeed in developing good vision. The role of your optician is very important.
L4E: What sort of preparation should a parent do before bringing their child in to pick out glasses?
Danielle: If your child is very young, make sure you arrive at a good time. For instance, don’t go at nap time or when they are hungry or sick. We want this to be a good positive experience. Remember you will be coming back often for adjustments and you don’t want your child to have such a bad experience that they cry pulling into the parking lot. Bring something from home that they are comfortable with, stuffed animal or blanket. Take some time to normalize your child to glasses. For instance, start by pointing out glasses. Show your little one that other people wear glasses, maybe mommy and daddy wear glasses. Make glasses for their favorite dolly or stuffed animal. This type of thing is so helpful for 2-4 year olds. If you don’t do it before you go in, you can still do it before you pick up their glasses, so fitting will be easier.
I think to help prepare yourselves as parents. It’s helpful to have an idea of a direction you want to go in. Think about how important durability is for you. Do you want something stylish? Do you want something that blends when worn on the face? It’s okay to think about the cosmetics. Often I see parents come in and they haven’t talked about this. If one parent has a different opinion from the other, you spend valuable time arguing/deciding in front of your child. This just makes the experience uncomfortable and drawn out. I recommend discussing lens options with the optician, they are there to guide you and let you know what is available.
L4E: Are there any “rules of thumb” that can help a parent figure out what size to start with? Are there certain sizes that are standard for certain ages?
Danielle: Fitting is always a “face on” decision. The glasses must be on for an optician to know if they will fit. The stamped on measurements are only a guideline. The one rule that you can definitely look at as a parent is whether or not your child’s eyes are centered in the glasses. This is universally recommended for a good fit and to make sure your child has the best fitting lenses. Frames that are too large will lead to lenses that are heavier and thicker than they need to be. The front is only the beginning. Always consider what it looks like behind the ears. If it is too long or too short, it will need to be modified. I recommend cable adapters for the youngest patients. Ask your optician if they will put them on. If you decide to go with a standard temples, then it should be molded and fit to just past the halfway point of the ear. If it’s too short, the glasses will not stay on properly. If they are too long the glasses will either fall off or be adjusted so tight that they cause red marks behind the ears. Don’t be afraid to ask the optician to adjust the sample glasses, so you can get a better idea of how they will fit. If the glasses look to big, they probably are.
L4E: Let’s say another parent runs in to the same problem that Megan did. They purchase glasses for their child and when the glasses come in, they realize that the fit is just not right at all, what should the parent do?
Danielle: Well, hopefully, some of this advice will keep that from happening. If you are uncomfortable in any way, it is best to keep looking. But if you find yourself in the position of having glasses that do not fit well, then please go back to the optician and express your concerns. Your child should not be wearing glasses that are too big or that your child will “grow into.” Glasses should fit well now and grow with your child for a while. I do frequent growth adjustments in the first year. But the goal absolutely is that they fit well over the entire time. I know from my early on experience, that often chain locations do not give the optician the resources to order frames in different sizes and colors. I also know that some smaller places don’t want to invest in children’s frames because they sell them so infrequently. This, of course, is not yours or your child’s fault. This optician should have ordered something smaller and if they were unable to do that should have apologized and sent these parents away to find something somewhere else. My hope is that some of this information will help you walk in a little bit more empowered to make good decisions WITH your optician and also help you feel comfortable walking away when you need to.
Thank you again to Danielle for taking the time to share her expertise!