My Child Needs Glasses, Now What?

Snellen chart for eye examAfter being an optometrist for almost fourteen years, I’ve examined hundreds of children who needed glasses, and I’ve seen many different reactions from children and parents alike. I also was a child who wore glasses. From my experience, I’ll share when to worry, when to let things slide, when to think about contacts, and maybe how to save yourself a little money along the way. It’s easy to go to the doctor and be diagnosed with less than perfect vision, but if your child needs glasses, what do you do next?

Making an Appointment

The American Optometric Association recommends that all children should have a vision exam within the first year of life and then again before school starts. Is this overkill? Maybe, but in my home state of Kentucky, a law was passed about a decade ago requiring all children to have an eye exam by a doctor before starting school. From the data collected, 25% of children examined have some sort of a vision problem that needs intervention. Not all were glasses. Some were perceptual or visual skills that needed help before learning to read. One out of four is a pretty significant number in my opinion.

Obviously if you notice problems like an eye that turns in our out, abnormally red eyes, if your child hates to have one eye covered, or has a strange looking pupil, you need to see an eye doctor. All kids sit close to the TV, so that isn’t necessarily a red flag. If your child is under 12 months of age, look for a doctor in the US who participates in a program called Infantsee. If you schedule an exam with a participating doctor, the first exam is free of charge for all kids under one. A six month old isn’t going to read the eye chart, but the doctor can tell if there is anything grossly wrong that needs treatment.

Older children can have an exam at any time. If you have vision insurance, you’d want to find a doctor who accepts your plan. Call first to make sure they see children, and confirm that they take your insurance. You don’t want to show up on the day of the appointment to find they don’t accept it.

If you don’t have insurance, call around to get a feel for each office or ask a friend. Websites like Yelp can also be helpful. You want this to be a positive experience, so if the doctor is a gruff, ex-military officer who sees few kids, it might not be the best fit. Ask the person who answers the phone if they do young child exams. You can tell right away if they are used to children or if that is a rarity. Children don’t need to see an ophthalmologist unless they require some sort of surgery. Getting a basic eye exam at an ophthalmology office would be like doing your routine physical with a cardiologist. You don’t need a specialist, and it will end up costing more.

The Visit

Make sure to let you child know that an eye exam is painless. The worst thing optometrists do is use bright lights and possibly eye drops. If your child is really averse to drops, tell the doctor. I would much rather the first visit be positive than do every test in the book. Healthy children usually can get by without eye drops unless there is some sort of a problem.

If your child does need glasses, keep a positive attitude. This is an example of one of the many negative responses I’ve heard from parents,

“Does Johnny have to wear glasses? I just hate my glasses and have to wear my contacts because I JUST CAN’T  wear glasses!”

Do you think Johnny is going to want to wear his glasses now? In the whole scheme of things, wearing glasses is a small issue when you consider all the possible things that could be wrong. Don’t make it a negative, and your child will be less likely to hate his glasses.

Buying Glasses

If your child needs glasses, you have several options. In my experience parents either choose to buy a nicer pair, maybe a memory metal that flexes and bends, with a good warranty, or they choose to buy the cheapest pair they can find because they expect their kids will break them. If they break, they just buy a new pair. Either way, it is rare to find a child under 12 that can go an entire year without needing some sort of repair or replacement if they are wearing their glasses regularly.

You don’t have to buy all kinds of special coatings for kid’s lenses. In the US, most lenses for children under 18 are polycarbonate, the thinner, lighter, more impact resistant material. Polycarbonate also has built in UV protection. All lenses come with a factory scratch coat, and since the prescription will likely change in a year, I don’t think paying for extra scratch treatments is worth it. Any lens can scratch, regardless of the treatments. The exception in lens options would be if your child has a really high prescription, usually over 3 units of correction. Then you might consider a higher index material. No one should have to wear Coke bottles with all the options available in today’s market.

If you are a loyal customer, an office is much more likely to work with you if your child needs an emergency repair or loaner frame. If you spend two hours looking, asking for your measurements, and writing down all the numbers to order online, that is your choice for sure, but don’t come back looking for favors if it doesn’t turn out like you expect.

What about Contacts?

Contacts can change a kid’s whole perspective and self esteem. I don’t have a specific age requirement for contacts, but kids need to be responsible enough to take care of their lenses. It almost never works if the parent wants it more than the child. Also, I’ve seen kids who were ready, but the parent had a strict age limit in mind. Junior high is one of the hardest ages as far as fitting in and trying to find your place in the whole hierarchy of adolescents. Contacts can be very affordable. Don’t let some pre-conceived notion stop you from allowing your child to try them.

My Kid Won’t Wear His/Her Glasses

I probably hear this once a day. My advice: Choose your battles. If your child is very farsighted or has a lot of astigmatism, school and reading will be harder if they don’t wear their glasses. If they have an amblyopic or lazy eye, it is likely to get worse without correction. Otherwise, it really isn’t that big of a deal. I was always nearsighted. I got glasses in 5th grade, wore them to school once, got made fun of, and never wore them to school again. I got contacts in 8th grade, and it was great, but I did fine in school , even without my glasses. Nearsighted kids can see to read, and that’s what is important. You learn to sit closer or listen well. I’m sure some might disagree with me, but I wouldn’t make it an argument every day. Older kids usually realize they need their glasses when they start getting headaches or won’t pass their vision test at the DMV when they start to think about a driver’s license.

If 25% of children need some sort of vision correction, odds are you might be seeing the optometrist at some point. It can be a very positive experience if you know what to expect and what to do if your child needs glasses.

Did you wear glasses as a kid? Do you have a scary optometrist story?

If you’re still awake after that whale of a post, don’t forget to enter the $1000 Giveaway, and check out my guest post for Debt Movement!

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  1. I am 14 Both my parents are near sighted and I think I am to I have a problem with my eyes since last year but Im scared to tell them because they always tell me not to read a lot or use technology a lot and my mom told me that glasses make a person look ugly I persona don’t want to wear glasses
    What should I do?

    1. I lost a contact lens when I was about 13 and I thought my Mom would kill me. They were very expensive back then. She wasn’t mad and just wanted me to be able to see as well as possible. I’m sure your Mom will feel the same way. It isn’t your fault if you need glasses.

    2. See the discussion immediately above. It sounds like your parents would support you if you wanted to try such an approach. You probably should still get your eyes examined, if for no other reason than to monitor their health.

  2. What about improving vision by exercises/training? A behavioral optometrist told me that nearsightedness which has recently developed can usually be reversed naturally. He said that actually reversing it takes a lot of work on the patient’s part, and his primary goal is stabilization. I realize that behavioral optometry is sort of fringe, but this optometrist gets referrals for problems such as convergence insufficiency (I have confirmed this with two other optometrists, who have referred to him.) He is also the official optometrist for two professional sports teams.

    There was also Antonia Orfield, an optometrist who reported reversing her own myopia by over 3 diopters (you can Google her; unfortunately, she’s now deceased.) Interestingly, the behavioral optometrist I talked to said that 2 diopters would be the most that one could hope to reverse, although he does believe that even high myopia could usually have been prevented. Yet another behavioral optometrist (who’s retired), told me that he once had a patient who reversed 6 diopters of myopia.

    1. There are some good behavioral optometrist out there, and vision therapy works great for some eye muscle and developmental problems, but it can be hard to know if someone is good or is charging $1000 for not very much. If nearsightedness is truly caused by near stress, it can sometimes be corrected with various types of glasses and/or exercise, but hereditary nearsightedness is what it is and all the exercises in the world aren’t going to help. The vast majority of patients, whether it’s eyes or other parts of the body, that are experiencing problems, want the easiest fix and aren’t willing to do months and months of therapy and be blurry in the interim for a treatment that may or may not work. If it was more concrete, it would be more useful. Myopia is certainly not the end of the world and actually comes in handy once presbyopia starts.

      1. Thanks for replying so quickly. The first behavioral optometrist I mentioned said that there are some cases where the genetic drive toward nearsightedness is too strong to be countered by any therapy. However, he seemed to think that this is more the exception than the rule, and most people would be able to avoid significant nearsightedness if it were addressed early on.

        Mild myopia is fine, but with high myopia, getting stuck without glasses could be a real disaster. Moreover, from what I’ve read, high myopia increases one’s long-term risk for a retinal detachment and possibly other serious eye problems. It is definitely true that most people want a quick fix and would not stick with a program like this, but people who are developing nearsightedness should at least get the chance. I can tell you that I absolutely would have given it my all, but my original optometrist made absolutely no mention of this option, and now I’m way too nearsighted for this to be practical even if it could theoretically still work for me (which it probably couldn’t.)

        I realize that conventional optometrists cannot be expected to individually help patients with this, or to routinely tell people who are going nearsighted to go to someone else if they want to try to reverse it. However, it seems like you could offer a handout to appropriate patients, with a disclaimer along the lines of: “The following exercises are sometimes used in an attempt to reverse or stabilize nearsightedness. While some optometrists have reported some degree of success in this regard, there is no conclusive proof that any such exercise is truly effective. Regardless of results, you should continue to get yearly eye exams, to monitor the health of your eyes. Always wear full correction for driving, or any other activity that requires clear vision.”

        I don’t know if any standard handout exists for this purpose, but I assume that behavioral optometrists who practice this do use some kind of handout, since apparently the exercises are supposed to be done daily.

      2. I do know that the retired behavioral optometrist I mentioned is working on a pdf explaining such exercises. The above disclaimer is something I first suggested to him, in hopes that he would create a version of it which regular optometrists might feel comfortable distributing (or at least pointing people to; I realize you might not want to use up paper to print copies.) I have no idea when he will complete a stable version, let alone if he will make a version tailored for regular optometrists.

        There are a few books about this written by optometrists, and many more written by laymen. I realize that it might be problematic just to vaguely tell people that this is out there if they want to look into it. However, if someone wants to try it, it would be better for them to do it right away, not years later when they’re more nearsighted and/or have more responsibilities, and then discover perhaps exaggerated claims of vision improvement somewhere, and then go around in a real blur while trying to apply it.

      3. Let me ask this: In your experience, do children and parents at least seem interested in stopping the progression of nearsightedness? From what I’ve read, that is somewhat more mainstream than trying to actually reverse it.

        1. I’ve had one parent ask about orthokeratology, which is a whole other process. I’ve never had any takers on trying to do vision therapy for halting or regression of myopia.

          1. Does “I’ve had one parent ask about orthokeratology” mean that you routinely mention that option, and only one parent has shown an interest? Or does it mean that this person had already heard about it somewhere else, and thus brought it up with you? Ditto for “I’ve never had any takers on trying to do vision therapy for halting or regression of myopia”?

  3. I was another one of those kids who wanted to wear glasses and finally got them when I was 15, when I failed the vision screening at school. At my exam I found out I was nearsighted and had astigmatism. Over the years I have always worn glasses, but I did try contacts for a while at the urging of my sister, to basically shut her up, but couldn’t wait to go back to wearing my glasses and had to break the news to her that I liked wearing glasses a lot better than contacts.

  4. Thank you for writing this – I felt so overwhelmed when the doctor said my son would need glasses, but this has completely helped me relax and understand.

    1. I’m so glad to help. Sometimes you get so caught up in the moment during the exam that you forget to ask the questions that you meant to. Feel free to email me anytime if you ever have anything you are concerned about.

  5. I took my son for his 6yr old check up and his pediatrician suggested he see an eye dr for a routine exam bc he read 20/30 on his screening. He has never shown any signs of having seeing problems. He is even in the gifted program at school, he plays soccer, hunts and fishes! The eye dr told me that he was legally blind in both eyes, he probably would never get a drivers lisence on and on of what he wasn’t going to be able to do. I was crushed!!! So I took him for a second opinion and that dr said about the same thing only gave him an even sronger prescription. How can this be? I’m very skeptical about getting him glasses because he has never shown any problems. I don’t know what to do. I have a lazy eye in my right eye and when I was little they told me I had to wear glasses all the time and I never did and my left eye has compensated for my right eye and I’ve never had any problems. So I don’t know if I should do the same for my son or put him in glasses but I don’t want him to become dependant upon them.

    1. That’s very strange is he was able to read 20/30 and the doctor said he was legally blind. Legally blind means that the best you can see even with glasses is 20/400. Some doctors use the tactic of saying you are legally blind without your glasses, but that is a horrible play on words because it doesn’t matter how strong your prescription is as long as it lets you see better than 20/400, which it seems your son is probably able to do. It’s hard to say without examining him, but I would be happy to review his records and give you an unbiased opinion if you’d like to email me at my contact address. I will say that you honestly never know how a child that young will develop, especially if he does have a problem and can get appropriate therapy while he is still young.

  6. Yep, have worn em since about 10. Terrible vision runs in our family. It really didn’t help that my mother made a comment to the effect that I wouldn’t be pretty anymore once I got glasses. When I got my eyes tested, they were seriously shocked that I was walking around. I knew my eyes were bad, but I never said anything for the longest time, despite being basically unable to see the board.

    1. That is a terrible thing to say. I’m sure she didn’t mean it, but still it obviously stuck in your mind. You do get used to adapting when you can’t see well. I’ve seen tons of kids who do that.

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