Bundles of Joy

The proper lens features are essential for kids to see their best and stay protected while wearing their specs. Here, we share strategies for putting the right lens on each young patient

By Susan Tarrant

Children’s eyewear is not like adult eyewear, with its myriad material choices, treatment options, and aesthetic considerations, each bringing different benefits depending on the Rx.

The quality of children’s vision directly affects their learning. And, as children are more active than adults, they need protection built in to their eyewear. Those considerations necessitate lens options specific to your younger patients.

MATERIALS

Kids need an impact-resistant material, period. That means polycarbonate or a Trivex material—each is basically equal in impact resistance. That’s where the similarities end, however.

So which one is the right choice? We found some varying opinions among ECPs, each valid.

■ Polycarbonate. Though its Abbe value of 29 to 30 is lower than other materials, polycarbonate is a great go-to material for impact-resistance, and therefore a staple in kids’ lenses. It is also lightweight.

At the kid-centric The Glasses Menagerie in Minneapolis, all kids are fitted with polycarbonate lenses. Pediatric optician Travis Brick puts his patients in an aspheric design for a more attractive lens profile (especially with the high-plus Rx’s).

■ Trivex. With an Abbe value of 43 to 45, Trivex has little color aberration and less visual distortion than polycarbonate. Also, with a specific gravity of 1.11, it is lighter than poly and has a higher light transmittance. It is optically superior to polycarbonate. But, it has a lower index of refraction and will be slightly thicker than polycarbonate. And, it is a premium material at a higher price.

Barry Montalto, ABOC, LDO, owner of Optique Unique in Metuchen, NJ, dispenses only Trivex to his young patients, who represent 20 percent of his business. The higher price for the premium material is not an issue at this high-end shop.

“[Parents] are dealing with their kids’ vision, and Trivex is the superior product for protection and optics,” he says.

■ High-Index. The majority of young children with visual issues are farsighted, so lens thickness can become an issue. Depending on the Rx and the child, some ECPs will recommend a high-index material, because the center thickness will provide added impact resistance while providing an attractive lens. But, remember your Duty to Warn, and explain the availability of impact-resistant materials to parents.

“I don’t think you can dispense anything other than poly or Trivex in good conscience without explaining to parents about the option of impact-resistant material,” says Danielle Crull, ABOM, owner of A Child’s Eyes in Mechanicsburg, PA. However, she acknowledges that, with certain Rx’s, high-index may be a good choice for young teens, as long as they are worn for dresswear and not activewear.

TREATMENTS

Children are formidable foes for lenses, as they can be tough on their eyewear. That fact, coupled with the inherent qualities of poly and Trivex that necessitate a hard coat, means a scratch or hard coat usually comes packed with the lens from the lab. Some manufacturers have developed super-hard coats for kids’ lenses.

But other treatments can be optional, and ECPs have differing opinions about what is essential.

■ Anti-reflective. At The Glasses Menagerie, every lens gets AR. Brick opines that AR provides for better visual acuity and more comfortable vision—something not to be messed with when dealing with kids.

“Kids are in so much fluorescent light at school,” he explains. “It’s important they see their best and are comfortable. What they see is how they learn.” A premium AR will be easier to clean, he adds.

The visual benefits of AR are important for kids, especially since they spend so much time in front of computers and smart boards in school, Crull adds. And she doesn’t dismiss the cosmetic importance for growing kids, either. But she doesn’t bother with AR for preschoolers.

Kathy Cooper, LDO, ABOC, of Madeira Optical in Cincinnati, OH, presents AR as an option for patients, explaining the benefits and letting parents decide.

■ UV protection. There is no question about the importance of protecting young eyes (and the skin around the eyes) from the effects of long-term exposure to UV rays. Whatever lens material you choose (with the exception of CR-39), UV protection is inherent in the lens. Let parents know you’ve got the UV issue covered.

■ Photochromics. Each of the ECPs interviewed for this story reports they talk about photochromics to patients and offer it as good solution for many children’s needs.

Putting a child in a photochromic lens has many advantages, not the least of which is the “cool” factor of having lenses that change. This can be a great option to get a child who is upset about having to wear glasses feel a lot better about the prospect.

They will also provide comfort in changing light conditions, which can be beneficial to kids with medical issues that make them light sensitive.

In addition, they can serve as sun protection without the need for the child to change eyewear or put on clips. Photochromic lenses also offer UV protection, just like all lens materials for kids.

When are photochromics NOT a great idea? Hardly ever.

Crull notes that she usually doesn’t recommend photochromics for very young children who are not light sensitive, as they can be bothered by the amount of time it takes the lens to clear indoors and, therefore, have another reason to try to take their glasses off.

FOCUS ON EYE HEALTH

Not every family is aware of the need for regular eye exams, and many times, unless there is an obvious issue with a child’s vision, he or she may not see an eyecare professional. It’s further reason why ECPs should get involved in education efforts in their community. Here is some food for thought from Transitions Optical, Inc.’s multicultural survey. The research found that though Americans value their eye health—and their family’s—few are taking regular steps to protect it. Last eye exam (adults) 41% within the year 4% never Last eye exam (children) 39% within the year 25% never

BUNDLES

With so many of the material/treatment decisions already made because of a child’s need for protection, the remaining decision is how to present them to the parents. Do you bundle in one package with one price, or do you add on as options are chosen?

Madeira Optical doesn’t bundle lens features for children, but it also doesn’t approach treatments like AR and scratch coating and even photochromics as “options.” Instead, they are all elements that can serve a patient’s need.

“Our doctors talk a lot about options with parents in the exam room, and then they make their recommendations,” Cooper says. “We prescribe what they need for the best lens and best vision for the child.”

At The Glasses Menagerie, Brick offers patients a standard pediatric vision lens package, which includes an aspheric poly lens with a scratch coat and premium AR. Photochromic lenses are offered as an option. If price becomes an issue, he will offer a lesser package that may include a standard poly lens instead of an aspheric design, for example, or a lesser coating with a shorter warranty.

“The more you present options, the more it seems you’re trying to sell them something,” Brick says. “Pretty soon, all the parents are seeing are dollar signs.”

Instead, focus on what the child needs for his or her Rx and activities. The standard kids package at Unique Optique is rather high-end, including Trivex with a premium AR and premium hard coat. Montalto advises working with your wholesale provider and lab to find the combination of material, coatings, and treatments that work well for your patients, and take advantage of pricing discounts that may be available to lower the price for patients.

SECOND PAIR

A second pair should always be your goal for young patients, not because of the extra sale as much as the fact that they need it—for sun protection, sports protection, or breakage insurance.

■ Spare. A spare pair serves children well, especially those who cannot be without glasses for a few days. That spare pair can be another full-fledged pair of perfect eyewear, or it can a dressed-down version of the primary pair, maybe with fewer options and/or discontinued frames to bring down the price.

■ Sports Protection. All kids who play sports and wear glasses should be fit with sport goggles. Eye injuries from sports are very common, and simply wearing poly or Trivex lenses isn’t enough. Talk to parents about combining the sports protection and a spare pair by making that second pair a sport goggle.

Furthermore, putting a photochromic lens in a sport goggle solves myriad needs, including adapting to the differing light conditions on and off the field and serving as sunwear or a spare pair if needed.

■ Sunwear. “Nothing beats the light and UV protection that you’ll get from a full-coverage sunglass with backside AR,” says Crull.

The key is approaching the dispensing conversation from the standpoint that the lenses are a medical need, Crull says, adding, “The perfect lens is the lens that meets all of the child’s needs.” EB