General Guidelines for Children with Refractive Errors

Television, Computer/Lap top, Ipad/Tab, Mobile gaming/PSP etc

  1. Upper limit for the duration of TV watching /day should be < 1 hour/day.
  2. Take a break for 5 minutes after 20 minutes of TV/PC/Laptop/Reading etc activities.
  3. Minimum distance from the TV should be 6 feet and from laptop should be 1 feet.
  4. Encourage the child to play in the garden/open ground especially in bright sunlight.
  5. Sunlight protects child from myopia – let sunlight brighten your houses.
  6. In house -artificial light- CFL/Incadescent has no impact on myopic progression.
  7. Rubbing of eyes is associated with increase in astigmatism, avoid rubbing.
  8. Balanced diet (vegetables/salad/fruits/milk etc) is necessary but does not affect refractive errors
  9. Wear spectacle full time. Full correction with spectacles reduces defocus and progression of myopia
  10. If progression is rapid (> 0.5 diopter/6months), atropine eye drops, progressive addition lenses, monovision and recently introduced (not commercially available) bioptic contact lenses can arrest / slow down the progression.
  11. Ideal age to dispense contact lenses for children is > 14 years age
  12. Ideal age to surgically correct (LASERs etc) the refractive error is >18 years
  13. 13.  Eye exercises / yoga / homeopathy / acupuncture / contact lenses (orthok) do not have effect on myopia progression!
  14. Parents having glasses / one child having spects is a risk factor, other children in the family must get an eye check up by 1 year of age to rule-out refractive errors

 Disclaimer: Above guidelines are based on current scientific literature and our experience.

Yours sincerely,

Dr Mihir Kothari,
MS, DNB, FPOS, FAICO, Diploma in Pediatric Ophthalmology and Strabismus (USA)
Fellowship in Pediatric Neuroophthalmology (USA), Ph: 9324037173 WWW.JYOTIRMAY.COM

How to choose the RIGHT spectacle for children?

Spectacle Frames:

  1. For children < 3-4 years age, MiraflexTM is the best, however, inform the optician to fit the lenses properly as they some times fall off.
  2. Half rimless / total rimless frames are best avoided in children – lens falling off / chipping is common.
  3. Plastic frames are better than metal frames in terms of retaining good fitting for long.
  4. Silicon nose rests/pads are useful to reduce pressure imprints on the nose.
  5. Round/oval eye wire is better than the rectangular ones as it covers the eye
  6. Middle level bridge provide better coverage while looking up as well as down  than a high/top level bridge
  7. A temple with side-spring is useful as it provides excellent fit for very long.

Spectacle Lenses:

  1. Avoid glass material as they have low safety profile.
  2. CR39 plastic is cheaper compared to Polycarbonate material. However, polycarbonate is tougher.
  3. Anti scratch coating is highly recommended for all plastic lenses.
  4. Anti reflective coating and/or high index lenses are necessary for >4diopter lenses only.
  5.  Bifocal lenses in children must have a large lower segment exactly as shown in the picture. They are expensive, more difficult to make and may need different/special frames so that there is a large upper as well as lower segment.
  6. Opticians often make mistakes in making bifocals in children. They apply their experience regarding adults in making those glasses for children. Make sure you have informed them not to do so.

Please do not handover your spectacle prescription to the optician. It may get misplaced.