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World Congress on Refractive Error Durban 2007

. . What Is Paediatric Dispensing?. Babies to mid teensYoung children, 4 - 11. . . What Makes Paediatric Dispensing Different?. More funThe duality of the clientThe larger difference between face and spectacle durabilityTime. . . Until around 1990s children were rarely given much thought Opticia

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World Congress on Refractive Error Durban 2007

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    1. Paediatric Dispensing David Wilson ICEE Australia World Congress on Refractive Error Durban 2007 The principles of aspheric lenses Written by David Wilson Head Teacher Clinical Technology OTEN Diagrams produced by: D Wilson International Centre for Eyecare Education (ICEE) Open Training & Education Network Education (OTEN)The principles of aspheric lenses Written by David Wilson Head Teacher Clinical Technology OTEN Diagrams produced by: D Wilson International Centre for Eyecare Education (ICEE) Open Training & Education Network Education (OTEN)

    2. What Is Paediatric Dispensing? Babies to mid teens Young children, 4 - 11

    4. Until around 1990s children were rarely given much thought Opticians had little to offer * frames were black or brown (or pink), two tone or full colour * lenses were toughened glass Spectacles were still largely considered as medical appliances (for children) Children were treated as miniature adults Possession of adults History of Children’s Eyewear

    5. but now We have designer frames and lightweight lenses More children are wearing spectacles * testing younger * more screening Changing image of spectacles Seen more and more as a fashion accessory Many of their heroes wear spectacles History of Children’s Eyewear

    6. But Children are no longer content to wear what their parents tell them More demanding and brand conscious History of Children’s Eyewear

    7. Age Differences Younger children (up to about 8 or 9) less likely to want spectacles Teens are more likely to recognize spectacles as an accessory When is a child not a child? When he or she says so! Have some small sizes on your adult display

    8. Frames - Technical Young children do not have a developed nose Characteristics of good kids’ frames * lower crest

    9. Frames - Technical Young children do not have a developed nose Characteristics of good kids’ frames * larger frontal angle

    10. Young children do not have a developed nose Characteristics of good kids’ frames * larger splay Frames - Technical

    11. Young children do not have a developed nose Characteristics of good kids’ frames * flatter pantoscopic tilt Frames - Technical

    12. Young children do not have a developed nose Characteristics of good kids’ frames * ability to shorten sides * spring hinges Frames - Technical

    13. Over 95% of frames dispensed to children are metals Make sure that the frames have no sharp edges and fit the above requirements Titanium is an ideal material for kids

    14. Face shape theory Soft curves for square faces Angular shapes for round faces Short face - shallow frame Colour matching Overriding consideration - be guided by the child

    15. Match width avoid the desire to supply frames that they can “grow into” Too wide means easily knocked off optical considerations such as aberrations and thickness kids will reject oversized frames

    16. Kids normally know what they like and are very honest They rarely have preconceived ideas about their image “We’re going to try everything on that fits you” Use terms like that looks cool or cute (relate language to age) and be honest Ask them “does this go in the good pile or the bad pile?”

    17. The ideal lens should be 1 Impact resistant 2 Light and comfortable 3 Able to cut out ultra violet 4 Relatively thin 5 Relatively durable Lenses - Technical

    18. Refractive index: nd = 1.586 Abbe number: nd = 31 Specific gravity: 1.20 gm/cubic cm Lenses - Polycarbonate

    19. Able to withstand a speeding bullet Able to fall from tall buildings with a single bounce More powerful than a locomotive Almost kid proof Lenses - Impact Resistance

    20. Fashion versus durability Comfort versus durability Safety versus durability Lenses - Prioritizing Conflicting Needs

    21. Take the emphasis out of durability Fashion- a child is more likely to wear frames they like than a sturdy frame In modern frames fashion and durability are not mutually exclusive Lenses - Prioritizing Conflicting Needs

    22. Comfort - children will not wear frames that are uncomfortable Again modern frames are also comfortable Safety - a critical issue What is more important, eyes or spectacles? Lenses - Prioritizing Conflicting Needs

    23. Lenses - Sport

    24. Scratched lenses lose their impact resistance Lenses should be changed regularly British standard BS6625 has two grades for children’s frames Grade B metal for younger children are not expected to last more than one year Lenses - How Long Should Spectacles Last?

    25. “Can’t consent to the practitioner’s negligence” OLA “Is CR39 too fragile for children?” The Optician (England) Lenses - Duty to Warn (duty to inform)

    26. Try to judge whether the parents are dominant If they are use phrases like “You need to like the frame but mum and dad need to like it too, they have to look at you” Have a quiet word with the dominant parent and point out the need for children to be involved If the parents are OK speak to the child Treading the Fine Line

    27. Kids like rules e.g. “Use two hands and lift up over your ears” Use rhymes e.g. “When they’re not on your face they live in their case” Use questions e.g. “Why don’t you put your glasses down on their lenses?” Communicating With Kids

    28. Use humor - e.g.“What’s the cleaning cloth for?” “What’s your shirt for?” Keep it light - joke with them Speak to them at their height - for little children, sit on the floor with the child’s parents Communicating With Kids

    29. Have a special display designed It should be colourful have mirrors at different heights The Kids’ Corner

    30. Sit next to the child with the parent behind the child, looking into the mirror with the child Have the toy box a little to the side (to amuse siblings) Give small gifts (balloons, small soft toys etc.) The Kids’ Corner

    31. Kids are use to being taught how to clean their teeth by dentists Optometrists and opticians should teach how to care for their spectacles Teaching Kids

    32. PDs older children - pupillometer younger children - PD rule very young children (or strabismus cases) PD rule (inner to outer canthus) involve the child in the task Measurements

    33. Centres as close as possible to geometric centres principal axis/ centre of rotation rule Measurements

    34. Bifocals segs set on pupil centre use a pre marked dummy lens Measurements

    35. Clients for life Parents and friends Extra special service now is a good investment for the future Practice Building

    36. THE END

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