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By: Jill Grattan & Alycia Burton 

Finding out your child needs glasses can be an unsettling experience, but it may also bring good news. Corrective lens can make a helpful difference both in your child's education and in your child's day-to day life. They may allow your child to have an easier time seeing your face, seeing schedules (e.g., object or pictures schedules), working on a tablet/computer, completing homework, and/or reading or looking at a book. Glasses can help your child see and recognize important people in his/her life, make it easier for your child to find and play with his/her toys, and recognize objects and places. Glasses may cut down on eye strain and headaches. Glasses do not have to be a traumatic experience for you and your child.  

Helpful terms from the American Association for Pediatric Ophthalmology and Strabismus

• Ophthalmologist - a medical doctor (a minimum of 8 years of medical training) who specializes in vision and eye care who can diagnose and treat all diseases of the eyes. An ophthalmologist can practice medicine and surgery in addition to prescribing eyeglasses and contact lenses.
• Optometrist - a healthcare professional (not a medical doctor) who provides vision care, such as eye exams, vision tests and prescribing glasses and contacts. Optometrists can detect certain eye abnormalities and prescribe a limited number of medications for some eye diseases.
• Optician - are technicians who design, verify, and fit eyeglass lenses and frames, and contacts. Opticians do not test vision, write prescriptions, diagnose, or treat eye diseases.

Tips to make a trip to the eye doctor easier:

• Before going to an optometrist or ophthalmologist, call ahead and ask if the ophthalmologist or optometrist has experience working with children with special needs. If the staff does not have experience working with a child with special needs, consider trying to find an office that does.
• Ask if they have experience fitting frames to the face of a child with unique facial features (for example, microtia, a condition in which a child has only one ear; many genetic conditions are signified by facial features of slightly different proportions).
• Ask if you and your child can visit the office before the appointment so your child can become familiar with the office and the equipment.
• Ask if the staff will allow extra time for your child to process the information
• Ask what times are the quietist or least busy and make an appointment accordingly
• Ask the eye doctor if there is a charge to re-fit your child’s glasses if the glasses get bent
• For more ideas and information, see our Tip sheet: Questions for Your Eye Doctor

When you and your child go to get the new glasses, there are two important things to verify before you start encouraging your child to wear his or her glasses.

1. The frames must fit your child’s head correctly. It is important to work with your child and his or her doctor to pick out frames that are appropriate and comfortable.
   1. Make sure the frames do not pinch your child’s nose or ears. This may require several trips to the eye doctor to fine tune; make sure to take the time and plan for multiple trips to ensure the glasses are comfortable. There are many different ways for glasses to stay on your child’s face – frames curling behind ears are only one option – ask about the options available and determine what is most comfortable for your child.
   2. When trying on glasses, have your child play -  glasses fit differently when lying on your back, than when sitting in a chair, or looking down to examine something on the ground. Make sure the glasses are comfortable and positioned correctly for your child in all of the positions he/she may play and work in. 
   3. Remember, even with modifications (like a sports band to hold the glasses in place), to have your child play in a variety of positions; the modification may work great when sitting, but may fail to hold the glasses in the proper place when your child is looking down.
   4. If you are having trouble getting the eye doctors to understand how the frames are not working for your child, take pictures of the situations in which the frames are uncomfortable. (More on this below.)
   5. If your child's glasses get bent, simply make an appointment with the eye doctor to get the glasses re-fitted to your child's face.
2. The lenses must match your child’s prescription and that prescription must be accurate and current. If your child is having a hard time wearing the glasses or if his vision is not improved with the glasses, have the prescription checked.
   
   1. Remember, your child’s vision may change throughout time. For example, a prescription may work one year, however, your child’s vision may change, so the prescription may not work the following year.
   2. To have your child’s prescription checked, make sure to take the glasses with you to the eye exam.
   3. It is important to ask if your child should only wear the glasses during certain activities or throughout the day.

Remember, your child needs time to adjust to the prescription. Your child’s vision with glasses is different from what had previously been his normal vision – this change in vision might make your child feel disoriented, dizzy, and/or uncomfortable until he gets used to the prescription. It might take time for your child to realize that he sees more clearly with glasses.

Ideas on how to help your child tolerate wearing glasses:

• If possible, have your child help pick out his/her own glasses. If your child helps to choose the glasses, she may like the glasses much better and be more inclined to wear them.
• Consider purchasing a really cheap pair of glasses or sunglasses (e.g., dollar store, supermarket) and practice wearing the glasses. Practice taking the glasses on and off and let the child experience what wearing glasses will feel like. If the glasses you buy for practice actually correct vision, then remember to take the lenses out so that the child does not get blurry vision from the practice glasses. Make it fun to wear the practice glasses!
• Initially, have your child wear her glasses during an activity she enjoys where the lenses will make the most difference (e.g., reading books, watching a movie, playing with toys, doing an art project). This allows your child to see the glasses really do make a difference. Make sure this activity is an interactive one between you and your child and that your child enjoys the activity.
• Build time into your child’s daily routine for wearing glasses. Initially, this time may be very short (e.g., 2-5 minutes). As your child demonstrates tolerance (e.g., does not complain, fight to prevent you from putting the glasses on her face, throw the glasses), gradually increase either the number of times per day the child wears the glasses OR the length of time the child wears glasses.
• Very slowly build up the length of time your child is required to wear glasses.
• Gradually, increase the number of activities in which your child is required to wear glasses.
• A timer may help your child tolerate wearing glasses – when the time is up, the glasses come off. Again, initially set the timer for short periods of time. For some children a visual timer may be helpful.
• Provide lots of praise for your child whenever she wears her glasses, keeps them on for the designated period of time, does not complain when you put them on her, puts on her glasses independently, etc.
• Initially, small rewards may be helpful (e.g., stickers, tokens, special toys that are only for wearing glasses). Deliver the reinforcer if your child keeps her glasses on for the designated amount of time.

Just as important as learning how to wear glasses, is learning to take glasses off in an appropriate manner. Teach your child to always hand his glasses to an adult when he takes them off. Praise your child for giving his glasses to an adult, even if he takes them off before the designated time For example, you might say, “Thank you for giving me your glasses. It is not time to take them off yet” and put the glasses back on your child.

Specialty frames companies that make glasses to customer specifications – for example, these companies advertise they make glasses for children with special needs and unique facial features (e.g., different facial proportions, children with one or no ears, children who wear hearing aids of all types). These companies are not endorsed by NDSIP – this is a list simply for your convenience:

References

• American Association for Pediatric Ophthalmology and Strabismus. (2011). Difference between and ophthalmologist, optometrist and optician.
• Anthony, T. (1996, September). Guidelines to parents on introducing glasses to young children. See/Hear Newsletter, Summer 1999.
• Fassler-Nelson, E. (March 27, 2015). Help! My special needs child has to get glasses.
• Weber, S. (2015). Kids need glasses; won’t tolerate anything on face.