The principles of prescription for children are completely different from those for adults because of their age and the presence of various congenital dysplasias that require treatment. The principles of prescription for children with myopia and amblyopia are very special, and if the child has a combination of “strabismus”, the principles of prescription are even more complicated.
I. Principles for children with dilated pupils.
For children under 8 years of age.
All children under 8 years of age should have their pupils dilated with slow-acting, long-acting atropine drops.
1. Children without combined strabismus and children with combined exotropia should have their pupils dilated with atropine for three days;
2, children with combined internal strabismus atropine pupil dilution for five days (try to eliminate the ciliary muscle adjustment factor);
3. Children with amblyopia, who are able to wear glasses regularly, should have their pupils dilated with the fast-acting “Medrol” eye drops before changing glasses (to relax the eye regulation);
For children over 8 years old.
1. If the child complains of poor vision at the first visit, use the fast-acting Medrol or Topamax eye drops to dilate the pupil;
2.After the dilated eye exam, the refractive error is obtained, and children whose vision cannot be corrected with glasses are referred to the amblyopia and strabismus clinic for consultation and treatment;
3.Children diagnosed with amblyopia should have their pupils dilated with atropine;
4, after the pupil dilatation, if only simple myopia, optometrists can directly retest after prescription prescription lenses;
5, optometrists for some special diopter children (high myopia, large astigmatism, progressive myopia children), you can ask the ophthalmologist consultation prescription program;
Second, children’s prescription principles.
1. Children with myopia, hyperopia and astigmatism without combined strabismus and amblyopia
1) Myopia is the lowest correction of the best corrected visual acuity, visual acuity can be corrected to 1.0;
2) Farsightedness minus the adjustment prescription, by the optometrist trial and according to the visual acuity and symptoms of the prescription, farsighted eyes after adequate prescription, need to reduce the adjustment of 100 degrees;
3) For children with myopia who do not cooperate with the examination, prescription lenses are prescribed according to the conventional method, while farsightedness is then subtracted by 100 degrees of adjustment, and then prescription lenses are prescribed.
2, amblyopic children with glasses (not combined with strabismus)
1) For children under 6 years old, correction of farsightedness and astigmatism should be done in sufficient amount, because the visual adaptation ability of children at a younger age is stronger;
2) Children aged 6-9 years old, high farsightedness should be reduced, astigmatism should be corrected in sufficient amount, and the number of farsightedness should be given in the second prescription;
3) Children over 9 years old with high hyperopia and high astigmatism should have their first prescription at 2/3 of the total prescription and be reviewed after half a year, and the second prescription should be full, because the adaptive ability of the eyes of older children is poor;
4) Refractive disparity children, the difference between the two eyes more than 300 degrees of the lower children can be more than the normal amount, both eyes to give the full amount of glasses. For older children, the prescription of the eye with the higher prescription should be reduced according to the situation.
3.Lens for children with amblyopia (combined strabismus).
If amblyopia combined with strabismus need to be treated, then according to the principles of amblyopia prescription lenses, do not have to consider the strabismus situation, after the amblyopia is cured and then according to the strabismus, or strabismus after surgery prescription lens principle for optometry.
4, strabismic children with glasses (not combined with amblyopia).
1) Exotropia, exotropia.
A. Combined with hyperopia, low corrective prescription (hyperopia is large, can aggravate the exotropia);
B. Combined myopia, adequate correction (myopia can control exotropia);
2) Internal strabismus, internal oblique
A, combined with hyperopia, adequate correction (hyperopia can control the internal strabismus);
B, combined with myopia, appropriate low correction (the minimum number of glasses to obtain the best vision);
C. Adjustment of internal strabismus, the child is farsighted need to correct all the prescription, change the lens according to the same vision machine examination results appropriate to reduce the prescription of farsightedness, should also ensure that the degree of strabismus does not increase the premise of reducing the degree of farsightedness.
Third, the optometry program for young children.
Some young children need optometry, but the child does not cooperate, and when the child grows up and then prescription lenses, and miss the best time for treatment. For this group of children, it is recommended to use oral chloral hydrate to dilate the pupil and then perform optometry.