Fitting kids with correctly sized eyewear is essential for the proper development of their vision. That means not too big and not too small. Over the years I’ve seen many children that have been fit poorly with glasses. Most often they are fit several sizes too big, causing them to slip down the kids’ little noses. Slipping down is often caused by a temple length that is longer than the distance needed to reach the back of the ear. Slipping down is never a good thing.

 

However there are times when a larger eye size may be ideal or even necessary. Generally, I look for the child’s eyes to be centered in the lenses of the glasses. This is considered “optimal fit”, but occasionally I run into reasons that this so-called “optimal fit” is not the BEST for my patient. 

 

When it comes to fit, eye size is only one part of the equation: bridge, temple length and overall width are equally important. However, while bridge and temple length must be perfect, eye size and overall width can be correct over a range of sizes depending on the circumstances. When a child requires this larger eye-size frame it is absolutely crucial that these other components are perfectly fitted. 

 

However, when stepping up to a  larger eye size the frame usually comes with a longer temple length that is too long for the child. These temple lengths must be customized to ensure a secure fit. Just because the eye size is larger, that is not a reason or excuse for the frames to slip down. A larger eye size frame, fit properly, will stay in position on the face and not interfere with visual development.

 

Here are 4 reasons why your child might benefit from a larger eye size, why you might see another child in a larger eye size frame or why you may need to fit your patient with a larger eye size. 

 

1. Nystagmus or wandering eyes: When a child has eyes that wander back and forth they need extra lens area to look through. Nystagmus causes short quick movements of the eyes, darting quickly back and forth. If the frames are small and limiting it could interrupt their vision. Also kiddos with nystagmus often have a “null point,” which is the position of the eyes that creates the least amount of jutting back and forth. When I measure a child’s pupillary distance I take special care to look for this null point. If it’s far off to the side, causing the child to turn their head to see the clearest, I will mark it accordingly. If I see that the child often turns their head to accommodate for this point, a larger eye size frame may be required so that they are not restricted by the edge of the frame when looking around. In this case, just a few millimeters larger on the eye size can make a big difference in the field of vision. 

 

2. Neck paralysis/ head tilt or head turn:  Like nystagmus, a head turn or tilt may require a slightly larger eye size. Some children may suffer from a neck paralysis or stiffness which may make it difficult to turn their head in the direction they need or want to see. 

 

Children who are in wheelchairs with restricted head rests also fall into this category. I have a young patient in a wheelchair whose daily positioning includes a tight head rest and a 45 degree recline. This caused a pseudo paralysis for him. He couldn’t move his head to see to the left or the right, only his eyes. If I didn’t fit him with a larger frame, his eyes would look beyond the frame and he would lose the benefit of his nearsighted prescription. The recline also put him at a disadvantage when looking at eye-level. If the frames did not extend far enough below his eye he would be looking under them. Special consideration should always be given when natural head movement is restricted in any way. Often a larger eye-sized frame can make a world of difference. 

 

3. Safety: Glasses can be prescribed for eye protection. If a child has poor vision in one eye, the other eye needs to be fully protected! A pair of glasses that does not completely cover the entire eye socket area would not provide adequate protection. Not only should the lenses be made to a special safety thickness and of polycarbonate, but they also need to be large enough to cover the check bone, and extend enough around the eyes enough to block fingers and debris from easily entering the eye area.

 

4. Craniotomy and  facial challenges: I’ve met many little children who have had surgeries on the skull and face area. When their glasses are being fit, it’s important to remember we are not just fitting the eyes, but the whole head. A substantial portion of the weight of the frame will be held by the sides of the head as well as the ears. Some kiddos may have scarring, swelling and sensitivity in the areas where the glasses touch. Care should be given to these areas! Sometimes a larger eye size is exactly what’s needed to take the pressure off. However, I do caution that you should still look for the smallest eye size that can be adjusted and molded to create the needed release of pressure. There is always a balance to consider. When using a larger eye size frame you may add unnecessary weight causing a problem, it’s a good idea to consider the overall weight of the frame and look for a frame that is larger, but also made of a lighter-weight material.  

 

I have another patient who was born with a growth outside of her left eye socket. This growth, while benign, has required many surgeries to repair and rebuild her eye socket. Those surgeries left her with a large amount of scar tissue and a bone that protrudes more than 15mm further out on the left side of her head. Fitting her with any kind of “optimal” fit on her lenses would leave her with pressure on that side of her head. I had to look for frames that were slightly larger, light weight and with temples that could be molded to go around her head without touching that sensitive area of her head. 

 

In a very fashion-centered adult eyewear world, “big” glasses are all the rage right now. But when fitting children, size is crucial. Anything too large will not stay on these active kiddos faces, and put unnecessary weight on developing noses. Since vision develops over the first 7-9 years of life, it’s paramount to make sure glasses fit perfectly during these ages. Sometimes this perfect fit may include looking for a larger eye size frame. 

If you've ever wondered what the inside of our office looks like, here's a short tour of our waiting room!

Every child deserves a well fitting pair of glasses. Keira is a sweet 9 year old little girl. This is a video about how we meet her special fitting requirements by customizing her new glasses. Bonus...lots of Keira smiles!

Hello!

My name is Max Crull. I maintain achildseyes.com as well as many of our other websites. I don't usually post on this blog, but I'm doing so to test our new RSS feed and see if I've coded everything correctly. I might be posting on the blog a few times until everything works. These posts will probably be removed once I'm done here.

Each RSS feed entry will have a short summary of each blog post, as well as a link to the full post. The summary itself will contain up to the first 1100 characters of the blog post. So, in order for me to make sure that works, I'll breifly describe what my role is in this business. This shouldn't take to long.

If you've been to our Mechanicsburg location, you've may or may not have seen a guy going back and forth in the hallway, or the top of someone's head behind a computer. If you have, then that guy was me. Unless you've seen my brother Carson, who also goes back and forth in the hallways and hides behind a computer. As we both have been told, unless you know us personally, it's very hard to tell us apart. My brother is a bit more social than I am, however. If you get a call from us, and you hear a man's voice instead of either Danielle's or Jax's, that was Carson. I usually don't touch the phone, and at times this has lead to a dropped call. If this has happened to you when you've called us, that was probably my fault and you have my apologies.

My main job in the business is to cut the lenses to fit your eyeglass frames. It's not too difficult of a job, although I have made some mistakes on a few jobs. I'm not perfect, then again no one is, but I am a perfectionist. This is kind of a curse as the slightest mistake can be a burden on my mind for the rest of the day. I do feel like I've gotten better over time.

Cutting lenses is not the only thing I do. As I've mentioned previously, one of my jobs is to maintain achildseyes.com, the website you are probably on right now. Unless you're not, then in that case I don't know what website you're on. Anyway, I'm planning on making a redesign to the website in the coming year. My dad, Eric Crull, was the one who designed it originally. It's served us well for the past however many years we've had it, but it's about time for a new look.

I also do a few odd jobs. One of them in vinyl cutting. If you've been to our new building, you may have seen some eyeglass frame shapes on the building. I've designed those, among many other things. If you've seen a vinyl sticker in the building, I've probably cut it. In fact, yesterday I made a label for one of Danielle's spontaneous craft projects. Here's a picture of it:

Yeah, in case you didn't know, we all love coffee!

Anyway, that is, for the most part, what I do at A Child's Eyes. It looks like I've written enough for me to submit this now.

One last thing before I go. If you guys are having any issues when using our website, please feel free to shoot me an email. You can also leave a comment here if you'd like.

Thank you.

SOUND OF FRONT DOOR OPENING

*Possible Frame count = 650*

(Someone’s here, must be a mommy, she’s holding a little guy’s hand and coming inside the door…He looks to be about 4 years old and she has a paper in her hand.)

*Possible Frame Count = 200*

“Hello, how are you?”

(he seems pretty happy, guess the doctor visit wasn’t too bad)

“I’d love to help you with glasses, do you have a prescription?”

(+4.50 in both eyes, Dr. Smith, was seen yesterday…I bet it’s a first Rx)

*Possible Frame Count = 150*

“Is this his first pair of glasses?”

(oh, wow, what a cutie…He has Superman on his shirt…wide head, maybe a size 44, maybe even 46)

*Possible Frame Count = 125*

“Great, looks like Johnny has a prescription that is a little high and he will want to and need to wear them all the time. He’s going to love them!”

(superman..mmm…I know I have one of those toys around here somewhere)

“So Johnny, do you like Superman? Or are you Superman? Or shall I call you Clark? Wait! Do you have cape under that jacket?”

 (haha, that got a smile on his face! Success!)

“I have a Superman Mr. Potato Head…want to see it? He even has a cape!”

(cool, now I can get him to look up, pupillary distance…smaller than average, maybe 25/25…cute little ears, beautiful blue eyes, mmm…what frames do I have with a small bridge?)

 “Hey, Johnny…watch this! Superman is going to fly right at you!”

*Possible Frame Count = 80*

“How about I put Superman here on the table and I’ll look for some super cool glasses we can try on?”

(I should probably put comfort cables on his glasses, he’s pretty active)

*Possible Frame Count = 70*

“He’s so cute, how did you know he would need glasses?”

(I thought I saw his eye turn a little…I better make sure the frame has room for a bifocal, just in case he needs one later on)

*Possible Frame Count = 50*

“What’s your favorite color? Is it blue like Superman? Or Red like Ironman maybe?”

(okay, blue glasses…size 44 or 46, I have to put cables on them, they need a small bridge…oh wait! I forgot to look at his eye lashes)

“Hey Johnny, look at this! I have a Superman Lego person too!”

 (yikes! How did I miss those LONG beauties? Boys always have the longest eyelashes, Optician’s Bane)

*Possible Frame Count = 20*

“Let’s put these glasses on and look in the mirror, I bet you look like Clark Kent.”

 (okay, that didn’t work…where did that extra hand come from, I swear kids sprout them at will.)

“Hey Johnny, Super Spud wants to fly these glasses over to you…Swishhhhhhhh…boop…peekaboo”

 (now he’s laughing)

“Look in the mirror. Wow, look how handsome you are! You look just like Superman!”

(oh gosh, he’s adorable. Ear lengths are different…I’ll need to modify both with comfort cables and at different lengths!)

*Possible Frame Count = 15*

“Yes, they are super cute…let’s try this one next. It’s just a little lighter in color and rounder in shape than the first pair”

“How about this one? I bet Super Spud can put them on you again….Swishhhhhhh…boop”

 (those eyelashes are gonna be a challenge)

“These are cute, but it won’t work with his eyelashes. We don’t want them rubbing at all, that can cause problems”

(better put all these frames back….eyelashes, always the boys)

*Possible Frame Count = 8*

(oh wait, I forgot about this frame)

*Possible Frame Count = 9*

“Hey Jonny, these are so cool, they have rockets on the side! Swishhhhhh…Boop!”

(is that a choir of angels I hear? These are perfect! The nose is perfect, the ears can be modified, and yes, the eyelashes have clearance!!!! Yes, yes, yes!)

“Yeah I can see that, the blue does look a little purple…especially in the light.”

(boogers …)

*Possible Frame Count = 8*

“You prefer something a little lighter? Okay, let me see”

(uh oh, REAL boogers this time)

“Looks like Johnny needs a tissue, it’s that time of year…here ya go.”

*Possible Frame Count = 2*

“I think these two fit the best. They both have spring hinges, I can fit them with these comfort cables to keep them nice and snug while he’s running around and they work well with his eyelashes. This one has a slightly lighter color and this one has red on the side. Let’s try them both on again….. swishhhhhh….boop…. swishhhhh…boop!”

(two frames that can be fit perfectly! I like the red ones a lot, they make him look like Superman for sure)

“You want Johnny to decide? Okay…Johnny which pair of glasses is your favorite?”

(pick the ones with the red, pick the ones with the red)

“You like the ones with the red?”

(yes!)

“Good choice, Johnny! You can play for a little while and I’ll talk to mommy, then I will measure your eyes for your new, super cool glasses!”

---

When it comes to choosing glasses, there’s more than meets the eye. From the parent’s point of view, you are concerned with the look on your child’s face, and rightly so. You look at your little kiddo every day. Your child has a unique personality and his or her glasses should be an expression of that. As you can see from the story though, there is quite a lot to be concerned with in regard to picking out glasses. Fashion and looks are great, but if the glasses don’t fit well, it doesn’t matter how good they look, your child will not be happy wearing them.  Not every pair of glasses can be fit or should be fit for your child. Finding that magic combination of a smart, cute look and a great fit is why seeking a trained optician is so important. From the eyelashes, to the potential need for bifocals, these things are what occupy the mind of an optician.