Riddle: When is the perfect frame NOT the perfect frame?

Answer: Every frame looks perfect when it's in the display

Oversize shoes are funny, oversize glasses are not: In Texas they say bigger is better. Well, not in the case of children's frames. First and foremost if it looks too big it is too big. A child's frame should fit right into the eye socket from top to bottom and not expand down the child's cheek. If a child is allowed to wear a frame like this it will cause unnecessary weight on the nose. Not only will this be uncomfortable, but it will cause the frame to slip down the nose and result in poor vision for the child. I've had many parents tell me that they have been told that their child is too big for kids glasses and needs to be in an adult-sized frame. While it is true that there are kids with larger-than-average heads, putting them in an adult frame would be a terrible mistake. An adult frame would not be as safe and would have side pieces that are 20-30 millimeters too long resulting in a very poor fit. So why would a parent be told that? Frankly, I have found that most places that tell parents this simply don't have that many children's glasses. There are plenty of children's frames in larger sizes to fit these kids.

Let's dispense with the pleasantries: Glasses never fit right when they arrive from the lab. They must be dispensed. That's a fancy word for fitted to the individual patient. Your optician should not just plop them on your child's head and hand you the bill. Let's start with balance: in order for a pair of glasses to wear properly they must have the entire weight of the glasses distributed evenly between the nose, side of head, and behind the ears. A child's nose bridge is still developing so it is crucial that the nose pads fit flat on the sides of the nose. The entire nose pad should be touching the surface of the nose bridge. I like separate nose pad arms instead of a molded plastic bridge because this allows me to adjust each side of the nose individually, accounting for any differences between the two sides. Once the pads are adjusted properly, the sides of the glasses should touch just above the ear with a slight amount of pressure. The side pieces should then wrap down behind the ear and stop just at its midpoint, creating approximately a 45 degree angle. If the side pieces are bent over at an angle greater than that, they they are too long and your optician is compensating instead of correcting. It is important to go just beyond the midpoint so that the glasses will stay on better. A cable side piece should wrap entirely around the ear and not stop short of the earlobe because this will be uncomfortable after an hour or two of wear.

Make your mark: Nose pads may leave light impressions on the nose after a day's wear but these slightly pink marks should be even on both sides of the nose and quickly disappear once the glasses have been removed. However, you should never find any marks on the sides of your child's head. If you do adjustments should be made in quick order to prevent the glasses from interfering with your child's normal head growth. Don't wait to do this one, because constricting growth can cause a permanent crease in the bone one the side of the head. Think of a tree which has grown around a wire fence. Remove the fence and you can still see the mark in the tree, even years later. Behind the ears, you may occasionally find light pink marks but be cautious those marks can turn into larger more painful abrasions over time. I always recommend parents check for these signs frequently to avoid their child not wanting to wear his or her glasses. Remember most kids care more about how their glasses feel than how they look!

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