Eyeglasses for Infants and Children

Why are glasses prescribed for children?

In most cases, glasses are prescribed for children to improve vision, as well as to prevent and treat amblyopia ("Lazy Eye") or eye muscle problems. There are also three different types of focusing problems which may require the need for corrective lenses.

These are:

• Myopia ("Nearsightedness")

• Hyperopia ("Farsightedness")

• Astigmatism

Myopia or nearsightedness is inherited and often discovered in children when they are eight to twelve years old. A myopic eye is longer than normal, causing light rays to focus in front of the retina. This causes close objects to look clear, but distant objects appear blurred.

Hyperopia or farsightedness is caused by light entering the eye and focusing behind the retina. A hyperopic eye is shorter than normal. Older people who are farsighted can see far away objects better than those close at hand. Most children are normally a little farsighted but have no problems seeing objects up close or at a distance. Hyperopia needs to be corrected in young people if it causes decreased vision or is associated with crossed eyes.

Astigmatism occurs when light rays enter the eye and focus at different places on the retina. It distorts and blurs vision for both near and far objects. In a normal eye, the cornea (front surface of the eye) is round, like a basketball. If you have astigmatism, the cornea is shaped more like a football.

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Can your baby's eyes be tested for glasses?

Your baby's eyes can be tested even before he or she is able to give a verbal response. By dilating your baby's pupil, the ophthalmologist can look at the retina using an instrument called a retinoscope. Lenses of varying power are placed on the front of the eye. The correct lens or power can then be determined. Read more about Your Child's Eye Exam >>

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How are glasses prescribed?

Your ophthalmologist will write a prescription for your child specifying the necessary lens power. You then take the prescription to an optical shop where a technician will grind or manufacture the lenses according to the specified power. A plus (+) in front of the first number means that your child has hyperopia, or is farsighted. A minus (-) means that your child has myopia, or is nearsighted. The higher the first number on the prescription, the greater the correction in the lens.

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Choosing a suitable frame

Frames come in all shapes and sizes, so it is important that you choose one that will fit your child's needs. Whenever possible, purchase the glasses from an optician who is interested in working with children. Ask him or her to recommend the most suitable frame style for your child's facial features, age, prescription and activities. Do not hesitate to ask about the quality and expected lifetime of the frame and the frame guarantee, if there is one.

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The importance of a proper fit

Because infants and children have relatively flat nasal bridges, glasses can easily slide down a child's nose. To prevent this, special attention is required when fitting the frames. There are a number of different devises available to use so that your child's glasses fit properly.

To prevent the frames from slipping, it is best to use rolled or flared nose pads. Silicone pads with nonskid surfaces are also useful, and sometimes rocking nose pads and arms need to be drilled into the nose bridge to obtain a good fit.

Cable temples (comfort cables) secure children's glasses by curling around their ears rather than pressing on the sides of their head. Cable temples are usually recommended for particularly active youngsters and are available for frame sizes worn by children one to four years old.

Flexible hinges allow for some outward bending of the temples, which is particularly useful for a child who pulls the temples away from their head when taking their glasses off. Flexible hinges are not essential with cable temples, but the combination tolerates more abuse.

Straps may be needed to replace ear pieces in very young infants. Elastic straps around the back and over the top of your child's head allow them to lie or roll on their side without discomfort or dislodging the glasses. The straps may need to be adjusted periodically. Generally, a child's frame will need to be increased in size by the age of 8 to 12 months. At this time, cable temples are often substituted for the straps.

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What types of lenses are the best?

Lenses are available in safety glass, regular plastic and polycarbonate. Glass lenses, because of their weight, tend to cause the frames to slide down a child's nose. If your child plays sports, polycarbonate lenses offer the most protection. They are made of especially strong, shatterproof and lightweight plastic. Plastic or polycarbonate lenses are lighter and safer than glass, but scratch easily.

Scratch resistant coatings can be applied to plastic and polycarbonate lenses, but some of these coatings will crack if exposed to extreme heat or cold. Ask your optician if the coating is guaranteed. Scratches cannot be removed but can be avoided or minimized with appropriate care.

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What about sunglasses, tints and photogray?

Prescription sunglasses can be purchased if your child needs to wear glasses at all times. The sunglasses should absorb at least 90% of the light including ultraviolet rays. Clip-on sunglasses are not usually available for children's frame sizes, but can be specially made by some opticians.

Tinted lenses made be recommended for certain eye conditions. Lenses which tint as the wearer goes inside or outside are available in glass only (Photogray or Photosun). These lenses are not frequently prescribed for children.

Ask your doctor and optician about the advantages and disadvantages of tints or sunglasses if your child is very sensitive to light.

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When should a child wear safety glasses?

Children who have good vision in only one eye should wear safety glasses for protection at all times, even if they do not need glasses otherwise.

Children participating in activities with a relatively high risk for eye injury such as racket sports, hockey, workshops or chemistry labs, should wear safety glasses for those activities.

Protective lenses should have 3mm thick polycarbonate lenses. Frames for safety glasses should be approved for industrial use or meet sports safety standards.

Prescription lenses are available for swimming glasses, ski goggles and scuba diving masks. Your optician can advise you in these areas.

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How to keep the glasses on your child.

Don't make a big fuss about the glasses. If your child is old enough, let him or her help pick out the frame. Be sure to follow your optician's advice about the proper frame size and fit because these are often more important than the appearance of the frame. Be positive about the glasses and your child's appearance in them.

Don't get into a tug of war with your infant. Try and distract him or her after you put the glasses on. If your child removes them, put them back on. If it happens again, set the glasses aside for a while and try again later.

If you have any questions or concerns about the fit of the glasses, take your child back to the optician. If your child continues to remove the glasses, call your ophthalmologist for further instruction and directions.

Your ophthalmologist will tell you how often your child should be wearing their glasses and what activities should be done without them. Be sure that you understand why your children should wear their glasses and what the consequences may be if they are not worn.

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Caring for your child's glasses.

Use water or liquid soap and a soft cloth to clean the glasses, not rough paper towels or tissues. To reduce wear and tear on the temples, children should be taught to remove their glasses using both hands. They should be shown how to put their glasses in a protective case and taught never to put them face down on any surface.

If the glasses appear to be out of alignment or fitting poorly, take your child and their glasses back to the optician.

In some cases, you can tighten the hinges at home with a small screwdriver. Do not replace any missing screws with wires, paper clips, glue or tape. This can be dangerous for your child, especially if the glasses are worn for sports.

See the Eye Safety for Children brochure for a list of approved frames and goggles.

This brochure was written in conjunction with the American Association for Pediatric Ophthalmology and Strabismus, an organization of pediatric ophthalmologists dedicated to the prevention and treatment of eye problems in children and the treatment of strabismus in people of all ages.

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Copyright © American Academy of Ophthalmology