Due to the characteristics of children’s age and the existence of various eye diseases that require treatment, the principles of prescription for children and adults are completely different, and the principles of prescription for children’s myopia and amblyopia are also very special. In order to standardize the dispensing of children’s glasses in our hospital, so that we can have a unified dispensing rule to follow, we integrated the rules of children’s dispensing in other hospitals in China and developed the following principles for your reference.
I. Principles of dilated pupils for children.
1. Children under 8 years of age: All atropine pupil dilatation optometry.
(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 should have their pupils dilated with atropine for five days (to remove the adjustment factor).
(3) Children with amblyopia, who can often adhere to wearing glasses, before changing glasses, the doctor will decide whether they can use Midori dilated pupil optometry (adjustment relaxation)
2.Children over 8 years old.
(1) Children with complaints of poor visual acuity at the first consultation, Midori or Toppingamide dilated pupil optometry.
(2) For those whose vision cannot be corrected after pupil dilatation, they should be referred to the amblyopia and strabismus clinic for medical consultation.
(3) Children with combined amblyopia should have their pupils dilated with atropine.
(4) After optometry, if the myopia is simple, the optometry office can directly retest and prescribe glasses.
(5) The optometry office can consult a doctor for some special prescriptions (high myopia, large astigmatism, progressive myopia).
(6) Children who need to ask for a doctor’s consultation will be directly added to the professional number by the optometry office.
II. Children’s prescription principles.
1.Non-combined strabismic amblyopia (non-combined amblyopia)
(1) Myopia is the lowest degree of correction for the best visual acuity, visual acuity can be corrected to 1.0.
(2) Farsightedness minus adjustment prescription, by the optometrist trial and according to the visual acuity and symptoms prescription (farsightedness minus 1D adjustment).
(3) For children who do not cooperate with the examination, myopia regular prescription, farsightedness and then subtract 1D adjustment prescription.
2. Dispensing for children with amblyopia (not combined with strabismus)
(1) Children under 6 years old, with adequate correction of hyperopia and astigmatism (low age children have strong visual adaptation ability).
(2) Children between 6 and 9 years old, high hyperopia should be reduced appropriately, astigmatism should be corrected in sufficient amount, and the second prescription should be adequate for hyperopia.
(3) Children over 9 years old with high hyperopia and high astigmatism should have 2/3 of their first prescription, and the second prescription should be given in full (older children have poor adaptive ability).
(4) For children with refractive error, the amount of spectacles can be given in excess of the normal amount for younger children (more than 300 degrees for both eyes). Older children should be given glasses according to medical advice.
3.Lens prescription for amblyopic children (combined with strabismus)
If amblyopia combined with strabismus needs to be treated, glasses will be dispensed according to the principles of amblyopia dispensing without considering strabismus, and then according to the principles of strabismus and surgical dispensing after amblyopia is cured.
4.Lens prescription for children with strabismus (not combined with amblyopia)
(1) Exotropia, exotropia
Combined with hyperopia, low-correction prescription (hyperopia is large, can aggravate exotropia).
Combined myopia, adequate correction, (myopia degree can control exotropia).
(2) Internal strabismus, internal oblique
Combined with hyperopia, adequate correction (the degree of hyperopia can control the internal strabismus.
Combined myopia, adequate low correction (best visual acuity, lowest degree).
Regulated internal strabismus, full correction of farsightedness with lenses, change lenses according to the same vision machine examination results to reduce the number of farsightedness, should ensure that the number of strabismus does not increase under the premise of reducing the number of farsightedness.