Kid's Korner
Fitting frames on infants and toddlers
By Marcy Bruch

Fitting infants and toddlers with frames poses special challenges, inspiring dispensers to consider pediatric eyecare a specialty unto itself. Aside from the rigors of fitting youngsters, dispensers are quick to point out that half the battle in building this part of the business is dealing diplomatically with parents.

When parents find out their tot needs glasses, they're often in shock. "The perception that they have this perfect child is shattered," says Rene Soltis, an optician and trainer for the VCA, who conducts the seminar The Psychology of Dispensing to Children. "Initially, the parent blames herself," Soltis says.

"If she wears glasses, she blames it on bad genes. Some mothers believe that if they had taken better care of themselves prenatally, the child wouldn't need glasses. So the first thing a dispenser should do is help parents get past the guilt," Soltis adds.

Fisher-Price style Teddy Bear for ClearVision

DISPELLING MYTHS

Before launching into fitting a small child with glasses, take a few moments to make the family comfortable. "When parents of tots walk through our doors the first time, they are usually emotionally dumbfounded, so I try to get them to lighten up before I start yanking a bunch of frames off boards," says Robert Silva, pediatric optician and manager of A Child's View in Mission Viejo, Calif. "I'll say something like, 'Relax, they're just glasses. It's merely a tool to help your child get through life with better eyesight.'"

Talking about the exact medical condition in non-threatening language helps put the situation in perspective and also helps dispel some of the myths about tots who need prescription eyewear.

In cases where the child may outgrow the need for corrective eyewear, Soltis says that she emphasizes the necessity of wearing glasses consistently. "Some people believe that if kids don't wear their eyewear all the time, their eyes will become less dependent on their glasses and their eyes will just correct themselves."

Once the parents gain a measure of acceptance that their tot does indeed need glasses, usually their next concern is how other people will react to their baby wearing eyewear. "Let's face it, when kids are 10 years old or more, they might think wearing glasses makes them look intellectual, even cool. But parents aren't going to think that about their tots," says Soltis.

	Osh Kosh style 552 frames from Avalon Eyewear

FIT FIRST

While eyecare providers, parents, and young patients want eyewear to look good, the top priorities in eyewear for tots should be fit and comfort. "If you address those issues first, you're more likely to get the tot to keep from pulling the eyewear off," Soltis says.

Proper bridge and temple fit, as well as lens alignment, are of prime importance when it comes to toddlers. Since toddlers have undeveloped bridges, dispensers should make sure the glasses don't slide down their patients' noses and the lenses are centered on the face.

"We only have about three vendors who have a large selection of frames for children in this age range," says Felipe Solano, an optician for Purdy's Optical in New York City, a dispensary that specializes in kids eyewear. These vendors, he notes, have been chosen because the frames they produce are available in eye sizes ranging from 32 to 35 and temples from 90 to 100 millimeters long, which is what usually fits best on tots.

Marchon's style Disney #53 for toddlers

METAL VERSUS PLASTIC

While some dispensers claim plastic frames are better for tots because they eliminate the risk of a child pulling off a nosepad and accidentally swallowing it, both Soltis and Solano say metal frames invariably sit on an infant's nose well because of the nosepads. Therefore, those frames can be a good bet.

"We've never had an incident where a toddler has swallowed a nosepad," says Solano. Adds Soltis, "Bear in mind the manufacturers of this eyewear know they have to make durable frames to endure a toddler's active lifestyle. So part of the anatomy of the frame will be nosepads that are on solid."

Knowing toddlers will knock around eyewear, Silva always makes sure he offers frames made of memory metal or other flexible material. "It's a given that this eyewear is going to take abuse, so you might as well give parents the strongest, most durable eyewear they can afford."

To keep the glasses snug on the toddler's head, there are both cable temples and head straps. "I prefer cable temples because there's a safety concern if a strap accidentally tightens around a child's neck," says Soltis. "Besides, cable temples are less obtrusive and look better."

"There are rubber cable temples out there that really keep the glasses on snug. What's more, glasses look less like a medical device when they aren't worn with a strap," Silva of A Child's View points out.

COAXING TOTS TO TRY ON

Of course, to know what fits a toddler, you have to get the frames on them, which is another challenge. "Playing peek-a-boo always works," says Silva. "I usually pull about five frames off the boards, and try to get them on the child as quickly as possible. Since there's not that big of a selection to begin with in this category, I know at least one of the five frames will work. Speed is of the essence here," he adds.

Solano says he grabs a toy or rubber ball with a bell from the play area to keep the child distracted so he and the parent can continue trying frames on the child while he or she is entertained.

Unlike shoes or winter coats, glasses must fit a child's face precisely before leaving the dispensary, notes Soltis, adding that eyecare providers have a responsibility to let parents know that children's eyewear will probably need updating on a regular basis. "Since kids at this age grow so fast, they will probably outgrow their eyewear within six months to a year. So they have to be aware that if the frame no longer fits, it's no longer effective as corrective eyewear. At $85 to $120 a pop for frames, that's probably not what they want to hear, but it's part of facing the reality that their child now needs prescription eyewear."

The good news is that once you've fitted frames on a toddler, you've built the foundation of a good relationship and can count on the parents' future business. "Parents never forget your patience with their child," Soltis says, "They'll remember your sensitivity during an emotional time for them."