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--- guidelines_for_prescribing_glasses_in_children [2015/12/28 18:55] – [Table] Scott Larson
+++ guidelines_for_prescribing_glasses_in_children [2025/12/01 19:26] (current) – Scott Larson
@@ Line 1: / Line 1: @@
+====== Guidelines for Prescribing Glasses in Children ======
+===== Preschool-Aged Children =====
+^ Condition                           ^  Refractive Errors                                  |||
+|                                     | Age < 1 year        | Age 1-2 Years  | Age 2-3 years  |
+^ Isoametropia                                                                             ||||
+| Myopia                              | ≥ -5.00             | ≥ -4.00        | ≥ -3.00        |
+| Hyperopia (no strabismus) ☆         | ≥ +6.00             | ≥ +5.00        | ≥  +4.50       |
+| Hyperopia with esotropia ★          | ≥ +2.50             | ≥ +2.00        | ≥ +1.50        |
+| Astigmatism                         | ≥ 3.00              | ≥ 2.50         | ≥ 2.00         |
+^ Anisometropia without strabismus ♠                                                       ||||
+| Myopia                              | ≥ -4.00             | ≥ -3.00        | ≥ -3.00        |
+| Hyperopia                           | ≥ +2.50             | ≥ +2.00        | ≥ +1.50        |
+| Astigmatism                         | ≥ 2.50              | ≥ 2.00         | ≥ 2.00         |
+| Oblique Astigmatism ♦               |  ≥ 1.00                                             |||
+☆ may under-correct by +1.00 to +3.00\\
+★ give full plus\\
+♠ Threshold for correction of anisometropia should be lower if the child has strabismus\\
+♦ Defined as >15 degrees from 90 or 180 meridian\\
+  * These values are based on consensus of expert opinion (see AAO source below)
+  * For children 4 years and older: prescriptions should be based on visual acuity measurements and visual functioning when at all possible
+===== School-Aged Children =====
+==== General guidelines: ====
+  - Glasses should be prescribed based on visual acuity testing at distance and near.
+  - An appropriate screening history should include questions about difficulty with near reading vision and distance vision
+==== Myopia: ====
+Prescribe glasses for children with distance vision worse than 20/30
+==== Astigmatism: ====
+Prescribe glasses for children with distance or near vision worse than 20/30
+==== Hyperopia without Esotropia: ====
+  - Prescribe glasses for children with vision worse than 20/30 at near or distance
+  - Prescribing glasses for children with 20/20 vision may be appropriate if vision is worse at near viewing or significant reading difficulty that appears to be related to poor accommodative effort.
+  - Glasses should have less than the full amount of hyperopia.
+    - The amount of under-correction can be based on the amount of hyperopia that improves vision
+    - The amount of under-correction can be from 1 to 3 diopters to help encourage glasses wear.
+==== Hyperopia with Esotropia: ====
+Prescribe full cycloplegic refraction
+==== Anisometropia: ====
+  - Correct the difference between the two eyes to within 1 diopter
+  - If one eye is hyperopic and one is myopic it may be appropriate to undercorrect the hyperopic eye by 0.5 to 1 diopter.
+  - When the child has reached visual maturity, glasses may be discontinued if desired by the family.
+===== Sources =====
+  * Preschool-Aged children information: Adapted from AAO Preferred Practice Pattern 2012, Pediatric Eye Evaluations p. 19 [[http://www.aao.org/Assets/7364f939-97b3-4c2e-948f-e6c3d78cb45d/634965436524370000/pediatric-eye-evaluations-pdf|PDF from AAO Website]]
+  * School-Aged Children is consensus from the Pediatric Ophthalmology Section, Department of Ophthalmology and Visual Sciences, University of Iowa
+{{tag>spectacles guidelines}}

spectacles guidelines