In Optician 20.07.18, we published an article looking at the dispensing of frames to fit younger children. The main point to remember is quite obvious – that a child’s frame is never simply a reduced version of an adult frame. For example, table 1 reminds us how the bridge changes with age and therefore other features important for appropriate frame fitting are also likely to change.
The source article also reminds us of the recommended step-by-step approach to adjusting a paediatric frame correctly:
- Pre-adjustment – the frame is first trued or set up
- Removing temple pressure – all pressure is removed from the temples
- Verifying equal vertex distance – the right and left angle of let back should not create unequal vertex distances
- Pantoscopic angle – should be close to zero to correspond to the facial plane
- Alignment of the bridge – the bridge of the frame should now be adjusted to fit the child’s bridge
- Temple adjustment – the temples are adjusted to match the contours of the child’s head
- Snugging – equal tension is returned to the temples from the top of the ears throughout the area behind the child’s ears.
Interactive Exercise
An interactive exercise is available online related to the best way to dispense a frame to a young and very active child for full time wear and what ought to be considered both in terms of the best fit and the appropriateness and robustness of the appliance chosen.
This exercise is designed to encourage discussion by both optometrists and dispensing opticians as either group might be expected to deal with the challenges either within or outside the consulting room. Obviously, each would be expected to answer according to their particular professional responsibility.
Before you attempt the exercise, there are six multiple choice questions which assess an overall understanding of paediatric dispensing. To ensure successful completion, read the aforementioned article on dispensing frames to younger children.