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Vision Screenings, Glasses, Contacts and Kids

Expert Chats

Now that the school year is back in full swing, it may be a good time to schedule those regular check-ups for your kids, including vision screenings.

But if you’d like a little more information before you go, we’ve checked in with Brittney Mazza, O.D., and Kimberley Chan, O.D., optometrists at Mass. Eye and Ear, for some answers to our most common questions about pediatric vision screening and correction…

What are signs that my child might need glasses?

There are a few things to look out for. In cases of moderate to severe farsightedness, children may complain of tired eyes, blurry vision, fatigue and/or difficulty with reading.  In some cases, an eye turn may be noted. Children with minimal farsightedness typically have no complaints, as their focusing system can keep images looking clear.

Children who are nearsighted may complain that objects look blurry in the distance, perhaps when they are trying to read something written on the board at school. Parents may also notice that their child sits close to the TV.

If a child has uncorrected astigmatism, they may complain that things look blurry at different distances (up close and far away). Astigmatism is a refractive condition that occurs when light is refracted unequally in different meridians of the eye, creating blurred vision.  It is often caused by an uneven shape of the front surface of the eye, the cornea.

In some cases, children may need correction even when they have no complaints at all, such as in the case of anisometropia, a condition in which one eye has better vision than the other. This condition sometimes causes amblyopia, or “lazy eye”, resulting in long lasting visual consequences if not treated.

When should children have their first eye exams?

Regulations on this vary by state. In Massachusetts, children must have at least one vision screening within the 12 months before they begin kindergarten. Infants and toddlers may require an eye exam earlier based on birth history, family history of eye problems or medical problems that may be suspected to cause eye problems.

A comprehensive eye exam is recommended if:

  • The child fails a vision screening
  • Parents or providers suspect a vision or ocular disorder
  • There is a family history of strabismus or other eye conditions that affect children
  • The child has a medical condition that is known to have associated eye problems, such as neurofibromatosis, Marfan syndrome, Down syndrome, or other genetic disorder

What do the numbers on an eyeglass prescription mean?

“OD” and “OS” are abbreviations for Latin words indicating the right eye and left eye, respectively.

There are typically three other specifications per eye written on the eyeglasses prescription:

  • Sphere or “Sph,” indicating the lens power to correct near (-) or farsightedness (+).
  • Cylinder or “Cyl,” indicating the lens power to correct astigmatism.
  • Axis, indicating the meridian or “orientation” without cylinder power, documented as a number between 1 and 180

What can I do if my child does not want to wear glasses or is worried about being teased?

Consider allowing your child to help choose a frame style or color they like, and select something that is comfortable to wear. Making the new glasses part of the child’s daily routine is recommended. It will help them to adapt in the beginning.  Let the teacher and school nurse know when your child should be wearing their glasses (full time, or part-time for certain activities). Finally, remember to keep a positive, upbeat attitude when discussing the topic and point out that other children or family members also wear glasses, too!

My child wants to wear contact lenses instead of glasses. What do we need to consider before making the switch?

The decision to wear contact lenses depends on several factors. There is no specific age minimum to try contact lenses, and every child is different. Your child’s level of motivation, responsibility and ability to comply with contact lens care are all very important factors. Children who are active in sports or have a high prescription often show an early interest in contact lenses as an alternative to wearing glasses.

Contact lenses are a great alternative to correct vision, but should not completely replace wearing eyeglasses. They are medical devices that require a prescription, and although they provide many benefits, there are still risks of infection and inflammation with wear. It’s important to follow your doctor’s recommendations for taking care of your contact lenses to reduce those risks.  Your child will have an eye exam first to determine if he/she is a good candidate for contact lens wear. Lastly, be sure to discuss the financial aspect of contact lenses, as many insurances do not cover the cost of the contact lens fitting or materials fees.

What types of contact lenses are available?

There are many types of contact lenses, but we most often recommend soft daily disposables for younger patients wearing contact lenses. These lenses are opened from a sterile package, worn once and then thrown away. Theoretically, there is less risk of infection, but there is still some risk. Daily disposables are an excellent choice for part-time wear, patients with allergies and especially patients who are not always compliant with proper contact lens care/hygiene.



  1. climatecool

    Awesome post Thank you for sharing.

    • Ryan Jaslow

      Thanks so much for your kind comment and for reading!