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Doctors, technicians and opticians all play a critical role in the potential success of a child’s visual performance—and some kids require a little more creative thinking by every care provider on the team. These unique spectacle wear challenges help to illustrate the many methods you can employ—including new frame technology, innovative lens design and motivating techniques—to ensure your pediatric patient’s spectacle success. Everyday Challenges with Real World Solutions Most pediatric patients are prescribed spectacles and instructed to return for follow up to check their response to the glasses after two to three months of wear. In cases where visual acuity has not improved with spectacle wear and amblyopic factors continue to linger, one culprit is often to blame: patient compliance. This child’s small pupillary distance and round head presents a fitting challenge. Non-compliance typically involves parents, peers, spectacle fit, prescription or some combination of all of these.

It is important to anticipate these reasons during your exam and address them when spectacles are first prescribed to increase the likelihood of good spectacle wear habits from the beginning. If we don’t, the child could completely miss the opportunity for improved visual development and be stuck with poor vision in one or both eyes. These cases exhibit the top reasons for non-compliance in the pediatric spectacle-wearing population: Pessimistic parent. A three-year-old black female was referred by her pediatrician for reduced acuity OD. She had anisometropic hyperopia OD>OS with reduced best-corrected acuity OD. She was a cooperative child, but as three-year-olds will do, she got antsy by the end of the exam. At this point, her mother said, “If you don’t sit still, they are going to give you glasses.” This negative take on glasses laid the groundwork for an uphill battle in compliance right out of the gate.

Solution: Your most formidable tool in combating a situation such as this is good communication with both the patient and parent. When you announce that glasses are the best vision correction option, it is important that the parent understands why glasses are prescribed, how they will help their child see better and what to anticipate when first trying the glasses. Reassure the parents that you only prescribe glasses when: (1) they are absolutely necessary and (2) they will improve the child’s quality of life.