I’ve noticed a few reasons why she has taken her glasses off that surprised me:

1. She was mad at me/dad/her siblings and this was her form of a tantrum
2. She sat in her carseat and the temples (arms) hit the seat pushing them forward
3. They got smudgy from oatmeal 
4. Someone at daycare tightened the strap too much
5. Someone at daycare loosened the strap too much
6. The strap twisted and was poking her in a weird way
7. She got a scratch on her nose and the nosepiece was poking her

So what do you do? Just try your best. Here are some tactics we have found to work most of the time:

1. Try not to react to your child removing the glasses because then it becomes a game that you do not want to play. 
2. Calmly replace them on their face.
3. Distract them from the glasses once you get them on.
4. No glasses? No ipad/TV/something they like. They will probably want to wear them while doing these activities anyway since their vision should be nice and sharp. 
5. Follow-through with any consequences, because kids are tricky and they will push the envelope. Just make sure the consequence is realistic and a natural one.

First timer? Here are some additional tricks getting used to them:

1. Start fresh in the morning. If you have the glasses dispensed to you in the afternoon, that evening might not go so well. Start the next morning right as they wake up so their eyes do not have a chance to compensate for their prescription.
2. Be encouraging. If mom or dad wears glasses it can help them understand that they need to wear them. There are a few books about wearing glasses and TV shows that address it.

I’ve noticed a few reasons why she has taken her glasses off that surprised me:

1. She was mad at me/dad/her siblings and this was her form of a tantrum
2. She sat in her car seat and the temples (arms) hit the seat pushing them forward
3. They got smudgy from oatmeal
4. Someone at daycare tightened the strap too much
5. Someone at daycare loosened the strap too much
6. The strap twisted and was poking her in a weird way
7. She got a scratch on her nose and the nosepiece was poking her

So, what do you do? Just try your best. Here are some tactics we have found to work most of the time:

1. Try not to react to your child removing the glasses because then it becomes a game that you do not want to play.
2. Calmly replace them on their face.
3. Distract them from the glasses once you get them on.
4. No glasses? No iPad/TV/something they like. They will probably want to wear them while doing these activities anyway since their vision should be nice and sharp.
5. Follow-through with any consequences, because kids are tricky, and they will push the envelope. Just make sure the consequence is realistic and a natural one.

First timer? Here are some additional tricks getting used to them:

1. Start fresh in the morning. If you have the glasses dispensed to you in the afternoon, that evening might not go so well. Start the next morning right as they wake up, so their eyes do not have a chance to compensate for their prescription.
2. Be encouraging. If mom or dad wears glasses it can help them understand that they need to wear them. There are a few books about wearing glasses and TV shows that address it.

1. Kids are quite adaptable, and their brains are as well. Unless an eye is turning in or out, it is almost impossible to spot if just one of your child’s eyes has a prescription and not the other. They might be covering an eye when they read or watch TV.  If your child does have a prescription in just one eye, this can lead to Amblyopia or “Lazy Eye”. This is a condition where the brain does not develop that side of the visual system properly and so the eye cannot see 20/20. If caught early enough, it is treatable. And the earlier it is caught, the easier it is to treat. Preferably this would be before age 5, but not after age 13 if it can be helped.
2. Eye rubbing is another way kids can show that they may have a prescription. Sometimes a prescription is low enough that kids can focus through, but their visual system gets very tired in doing so. Eye rubbing is a response to this. (Side note: it could also be allergies, but I do not want any kids chronically rubbing their eyes as it has been correlated with Keratoconus).
3. Squinting: I mean, that’s kind of an easy one. BUT, sometimes it looks cute! My daughter would squint when she was crabby and 2 yrs old. We thought she looked like Clint Eastwood and thought she was being goofy. Nope, she needed glasses. See? Even I had trouble spotting that one.
4. Headaches: Now, the tricky thing about this one is that KIDS DON’T TELL YOU ANYTHING. I’ve had many parents sit there with their jaws on the ground because their child suddenly confesses to regular headaches when I asked. So, I’ll say it again: kids don’t tell you anything.

So what should we do? I love pediatric screenings and vision screenings at school, but they will absolutely not replace a full dilated eye exam. I recommend them under 1 yr old, and then every few years after that (or more frequently if your doctor is following them for a prescription change). I have a couple of techniques that I do not use on adults to help me get a prescription on a kid that does not require them to be verbal or even cooperative with reading the chart.

I was referred three kids this week anywhere from age 6-15 who had struggled with their vision at the pediatrician’s office. All three of them needed glasses, and only one of their parents had any idea that they might need correction. There are a few things about kids that will help you understand why they don’t tell you they are having trouble with their vision:

1. They don’t know that blurry or double vision is abnormal. How would they? Until we ask them to read smaller letters that are carefully measured are we able to figure out there may be a problem. Asking them if they can read a sign on the road doesn’t count – there are other cues that can be used to figure out what it says that are not vision related.
2. Kids are amazing at adapting. Can’t see well? They learn to use their hearing instead in school. One eye is blurry? Brain ignores it instead and delays its development (amblyopia). There is no way to tell if this is present without an examination.
3. They can over-focus and compensate for their prescription until it’s just too much. Up close reading time increases as they move up in school, so they may just avoid it altogether. One of the kids this week had been in remedial reading to help him when really it is his vision.
4. They don’t know how to describe their vision even if they knew it was abnormal. Even adults have trouble explaining to me what their vision is like sometimes.

The pediatrician screens for kids who are unable to read 20/30 or smaller, which is a wonderful benchmark to go by. But, like I said above, some kids are able to over-focus and compensate for their prescriptions when asked to do so. I would encourage parents to get their kids vision checked even if they pass this screening if they notice the following:

1. Struggling with reading or schoolwork
2. Headaches
3. Rubbing eyes
4. Closing one eye
5. Getting close to papers, devices or TV
6. Squinting
7. Blinks a lot
8. Eye turns out or in when tired
9. White pupil when photo is taken with a flash
10. Biological mom and/or dad has glasses or contact lenses

How old do kids need to be to have an eye exam? Great news is it can be done at ANY age. They don’t even need to be able to read letters or know their shapes. I have methods and tools to perform exams on babies, non-verbal, etc without them even needing to say a word to me.

Kids will almost always be dilated with eye drops to get an accurate prescription and thorough view of the health of the back of the eye since they can be so wiggly.

As they grow, their eyes grow and change just like the rest of their bodies. So, while they may not have a problem one year, that can quickly change. Kids sure do keep us on our toes, don’t they?

One final note: a pediatrician screening is not a substitute for a full exam by an eye doctor. You don’t often need to be referred to see an eye doctor for a routine exam. I recommend eye exams for every single person since it takes the guessing out of what may be going on with your child. Preventative care is so much easier than trying to catch up later.