Children’s Glasses

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  • Objective refraction in cycloplegia until at least 14 years of age (use Cyclopentolate 0.5% before 6 months old, thereafter 1%
    • alternative: Mydriaticum (tropicamide) 4x every 5 minutes, then 15 minutes after the last dose -> refraction
    • alternative: Atropine 0.5% once in the evening before and on the morning of the appointment by parents (appointments not before 10:00 am))
  • At birth: Eye closure in response to light
  • From 7 days postnatal: Vestibulo-ocular reflex
  • From the 2nd month of life: Good fixation
  • From the 4th year of life: Visual acuity testing
  • From the 7th year of life: Subjective refraction possible (Cave: Accommodation!)
  • +/- orthoptic examination

Prescription in cases of ametropia without strabismus

  • Hyperopia: > 3 dioptres (> 4 dioptres according to Kanski), consider initially 1 dioptre under-correction until the child adapts to the glasses (in cases of high refractive errors, full correction from the first pair of glasses)
  • Myopia: Before the 2nd year of life, correct values > 5 dioptres or more (according to Kanski); > 8 dioptres from the 2nd year of life full correction; Cave: no under-correction!
  • Astigmatism: > 1 dioptre (> 1.5 dioptres according to Kanski) full correction (from 10 to 12 months of age; exception: with symmetrical astigmatism)
  • Anisometropia: > 1 dioptre full correction (from the 3rd year of life according to Kanski)

Indications for glasses

  • Generally: Glasses correction earliest from the 1st year of life (exception: Aphakia after congenital cataract surgery)
  • Hyperopia: Up to +4 dioptres without strabismus should generally not be corrected in children, unless there are problems with near vision. For hyperopia > 4 dioptres, usually 2/3 of the correction is prescribed. However, if esotropia is present, the full cycloplegic refractive value must be prescribed, even if the child is not yet 2 years old
  • Myopia: Until the 2nd year of life, only refractive values > -5 dioptres should be corrected; between the 2nd and 4th years, those > -3 dioptres. In children from the 5th year of life, lower levels of myopia can also be corrected
  • Astigmatism: A cylinder of > 1.5 dioptres should be corrected, especially in anisometropia after 18 months of age
  • Anisometropia: After the 3rd year of life, the full different refraction of both eyes should be corrected if the difference is greater than 1.0 dioptre. If no strabismus is present, associated hyperopia in both eyes can be equally reduced

Glasses Prescription

  • Hyperopia: ≥ +5 dioptres
  • Anisometropia: ≥ +1.5 dioptres
  • Myopia:
    • Up to 1 year old: ≥ -5 dioptres
    • 1-6 years old: ≥ -3 dioptres
    • Older than 6 years: ≥ -1 dioptre
    • Anisometropia: ≥ 3 dioptres
  • Astigmatism:
    • Up to 1 year old: ≥ 3 dioptres
    • 1-6 years old: ≥ 2 dioptres
    • Older than 6 years: ≥ 1 dioptre
    • Anisometropia: ≥ 1.5 dioptres

Mittel- und Gegenständeliste (MiGeL)

Liste des moyens et appareils (LiMA)

Elenco dei mezzi e degli apparecchi (EMAp)

Adult Glasses Prescription

  • see separate article