Kids' glasses
A children's glasses is a visual aid for the correction of refractive and position errors of the eye in infants, toddlers and school children as well as adolescents. It has to meet its own requirements in terms of material, workmanship, size, wearing comfort and, above all, acceptance. Children's glasses therefore differ in many ways from those of adults. In Germany, the costs for children's glasses are not covered in full by the health insurances and, depending on age, up to the age of 18 only within the framework of different flat-rate fixed amounts. According to the professional association of ophthalmologists in Germany (BVA) and the German Ophthalmological Society (DOG), around 20% of all children need glasses . Other sources speak of over 30%.
Prescription criteria
The prescription of glasses in infancy or childhood almost always has a medical - therapeutic background. Ametropia such as farsightedness , nearsightedness or asthma can impair the normal development of vision in early childhood and must be corrected in good time with the appropriate glasses. Otherwise there is a risk of irreversible impaired vision ( amblyopia ), which later can not be cured even with optimal glasses or contact lens correction.
Another criterion for the immediate provision of glasses is an impending or already existing strabismus . Here, the risk of amblyopia is even higher due to not using the cross-eyed eye ( suppression ). Even with fully developed visual acuity , this risk persists until the beginning of puberty. In addition, in some cases the glasses can influence the position of the eyes and thus the two-eyed vision , which is why correction is necessary as early as possible. For this purpose, spectacle lenses have a so-called prismatic effect in certain cases , which changes the beam path of the light through the spectacle lens. This property can be achieved by working a prism directly into a glass or by sticking it to the glass using a film that can be removed at any time.
Eyeglass correction may also be necessary for older children and adolescents who do not suffer from strabismus. In the case of existing myopia, the visual acuity decreases with increasing distance from the object being fixed. With farsightedness, nearby vision is often inadequate and symptoms such as headache, tiredness, burning eyes and lack of concentration etc. occur. This type of complaint is summarized under the term asthenopia . Among other things, they can be triggered by excessive so-called accommodation . This mechanism is usually used to adjust the eye to different object distances, but can also be used to compensate for an existing farsightedness. With astigmatism (also: astigmatism ), the distance is hardly relevant and the visual acuity is reduced at any distance. In addition, the optical conditions of the eyes change with the growth and development of the children. It is therefore not uncommon for a child, for example, to only get their first glasses at the age of 10 or 12, even if a defective vision could always be ruled out beforehand through regular checks.
Accordingly, glasses are required for children regardless of age if:
- there is a refraction- related reduction in visual acuity (caused by ametropia) in the distance and / or near,
- higher-grade ametropia exist, even if they do not directly lead to a deterioration in visual acuity,
- asthenopic symptoms occur, which are reduced or even eliminated by a suitable correction or
- a strabismus is imminent or already present.
Lens determination
Like other glasses, children's glasses are made and delivered by an optician . Before that, certain ophthalmological examinations (objective and subjective refraction determination ) are necessary to determine the refractive power and lens thickness . At least when the objective refraction measurement is carried out for the first time , it must be prepared with special eye drops for short-term expansion of the pupil ( mydriasis ) and the elimination of accommodation ( cycloplegia ). Only in this way can the actual values of ametropia be determined precisely in children , since otherwise the involuntary impulse for accommodation could falsify the measurement to a considerable extent.
If necessary, a further examination of the subjective refraction is necessary in order to determine the final spectacle values. If a prism regulation is also necessary, further special examinations are carried out to determine the prism strength and base position . All determined values are entered in a glasses prescription , which is given to the optician for the production of the glasses.
properties
The features and quality of children's glasses vary from product to product. In general, however, they meet the basic requirements with regard to typical activities, occupations and the increased urge to move in all aspects of durability, functionality and safety. They are a tool that has certain limitations. At the beginning, they are perceived as foreign bodies and in a certain way reduce the field of vision . Badly fitting or oppressive glasses are rarely tolerated and are reluctant to wear, as they tend to be a hindrance when playing or in other situations. Optimal children's glasses will therefore compensate for the obvious disadvantages with positive properties.
Glasses
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| +3.00 dpt: too heavy | +3.00 dpt: good |
The size of the lenses is primarily determined by the frame. Diameters of around 23 to 35 millimeters are sufficient for children. The smaller the blanks are chosen for the later lenses during manufacture, the lower their weight and the overall weight of the glasses. A high percentage of the glasses in children's glasses weighs less than 10 grams.
As a rule, spectacle lenses are made of mineral glass . By choosing plastic glasses ( CR-39 ) the weight is further reduced. Plastic has the advantage of being resistant to breakage, but it scratches much faster than glass. On the other hand, special lacquer hardening helps, but is not paid for by health insurance companies .
Highly refractive glasses are thinner than normal standard glasses with the same strength and achieve a more cosmetically positive effect when looking at the glasses from the side for higher-grade ametropia . However, from a medical point of view, they do not offer any advantages.
Tints reduce the incidence of light and can therefore worsen visual acuity. Therefore, they are only useful for children in exceptional cases.
Anti-reflective coatings reduce annoying light reflections on the spectacle lens and thus ensure more comfortable vision, especially under artificial lighting conditions. A simple anti-reflective coating is sufficient for children's glasses. The additional costs for this must be borne by yourself.
Version
too big, slips
Well
too heavy, presses
Well
Special requirements are placed on the material and appearance of the frames of children's glasses. Optimal children's glasses are light and flexible, but also very stable and durable. It sits well and tightly without pressing and meets the needs of the child in terms of its design and shape.
The material of the frame is an important criterion for compatibility and durability. Usually different metal alloys or plastics are used that meet the high requirements. If allergic reactions occur when wearing or if allergies to certain substances are known beforehand, this must be counteracted by a suitable choice of material or special coatings. Manufacturers offer a range of solutions here. Particularly flexible and durable frames, which can be bent almost at will without any problems and which spring back to their original shape automatically due to the material properties, are made from a combination of titanium and steel .
The size of the frame depends on the size of the face, the size of the eye socket ( orbit ) and the existing eye relief . The outer boundaries should end upwards under the eyebrows and still leave them visible, which is important for the facial expression. At the bottom they are in the border area between the skin of the eyelids and the cheekbones , without resting on the cheekbones. To the side, they reach no more than the edge of the temples . The smaller the frame is chosen, the lower the associated restrictions. In particular, the occurrence of visual field restrictions in the case of higher myopia and farsightedness can be reduced to a minimum by using a smaller frame and lenses that are close to the eyes. However, it must be big enough to prevent you from looking over it when you look up.
The frame is worked precisely in compliance with strict centering regulations (RAL-RG 915) so that the lens center and thus the position of the optical center of the lenses corresponds exactly to the pupil center . The center-to-center distance (MA) of the frame must correspond exactly to the distance between the eyes (pupillary distance = PD) from one another (MA = PD).
hanger
Eyeglass temples must be long enough not to cause pressure points, but ensure a secure fit. In order to cope with a more pronounced urge to move, special temples are often offered for children's glasses, which reach behind the ear almost to the earlobe and with an elastic component ensure a secure hold. They are called webbing, imperial, articulated or sports temples and are often found on the frames of adult sports glasses . A plastic cover on the flexible part that runs behind the ear often helps against possible pressure points or allergic reactions.
Another variant that ensures a secure fit is an elastic rubber band that is attached to two straight, not bent, brackets and runs behind the head.
The temples are generally attached to the frame with small hinges. Plastic caps that are pulled over the hinges can reduce the potential risk of injury here. In addition, it is possible to equip the stirrups, which are usually stiff from an opening width of around 90 degrees, with spring hinges, which enable movement beyond the right angle and thus ensure more durability and flexibility.
For babies and toddlers, there are all-plastic frames that are equipped with temples without hinges and are held in place by a rubber band. It is possible to work the glasses into a cap so that the child cannot tear them off.
Nasal bridge
Side bridge
Saddle bridge
The nose carries a large part of the weight of the glasses. In order to avoid slipping or the formation of pressure points, the contact surface of the nose bridge is therefore correspondingly large. In children, the bridge of the nose is not yet fully developed ( epicanthus ). In order to take this anatomical fact into account, there are special saddle bars or loop bars made of plastic , which offer a wide and evenly distributing support surface. In addition, they can be shaped and adapted within certain limits by the optician. Side bars with pads of different strength , which in turn can bend more easily and represent wear parts, offer even better individual adaptation to the bridge of the nose . They must therefore be changed at certain intervals.
Acceptance criteria and motivation
The first pair of glasses for children (as for adults) usually takes a certain amount of time to get used to them. Besides the unfamiliar “foreign body”, the main cause is the changed visual impressions. In addition, acceptance will drop significantly if children's glasses alienate or even disfigure the face.
Children are rarely averse to wearing glasses when they suit their needs. It has therefore proven to be advantageous if you can choose your glasses yourself within the framework of the recommendations. There is also an association with growing up , which in connection with a positive attitude of the parents towards glasses has proven to be a further acceptance criterion.
Since glasses are primarily used to correct ametropia, they increase visual acuity to a certain extent. So there is an immediately noticeable improvement for children that makes intensive persuasion to wear glasses superfluous in most cases. However, this is not necessarily the case with all types of refractive errors. There are certainly cases in which children do not see much better with new glasses, sometimes even worse than without the new correction. This is because, in certain respects, the eyes have to get used to the glasses. Talking about it beforehand can prepare children for such a situation. If you consistently wear the glasses, it will be gone in a few hours to a few days anyway.
Children's glasses can withstand a great deal of stress in order not to unduly restrict the child's usual freedom of movement. However, after a certain period of time you will suffer from intensive use. Accusations on the part of the parents should be avoided in such situations, as experience has shown that they significantly reduce acceptance. In most cases, the optician can repair many wounds and minor damage.
Only in exceptional cases do children’s glasses have to be worn temporarily. The rule is permanent use of the correction, which children should be truthfully informed about.
Children's glasses do not pose a higher risk of injury during sports and games. Exactly the opposite is the case. It has been shown that they protect against injuries rather than cause them. However, if children do a particular sport very intensively, they should wear special sports glasses suitable for this .
Controls
Regular checks of children's glasses are necessary for two reasons. On the one hand, intensive use will often lead to the frame being bent or the lenses being scratched. Since an optimal fit and the best possible image quality are essential, appropriate controls cannot be avoided. On the other hand, the development and growth of children change the optical refraction of the eyes. This leads to the fact that the once determined glass thickness no longer corresponds to the current requirements after a certain period of time and has to be adjusted. The time intervals at which this happens are individually different and are related to other findings. Unless otherwise instructed by the ophthalmologist, a check-up within 6–8 weeks is necessary after the first prescription of glasses to check whether the medical and functional expectations have been met. Further checks are to be carried out at regular intervals by arrangement. If there is amblyopia or strabismus, eyeglass controls can be carried out as part of the ophthalmological examinations. Otherwise, regular visits to an optician are recommended to check glasses and visual acuity. If it is found that the eyes have changed significantly, a new lens determination should be carried out by an ophthalmologist, again using eye drops if necessary.
Health insurance costs and benefits
The cost of making children's glasses depends on the quality and equipment. There are certain standards that can be implemented with less financial outlay, whereas complex processing or special materials result in higher costs. The statutory health insurance (GKV) in Germany differentiates between lenses and frames when it comes to costs. She does not cover the costs for the frame, those for glasses up to the age of 18 at the latest only within the framework of a flat rate based on the age of the child and the glass thickness. If it is not a first-time supply, but a re- prescription, you are only entitled to reimbursement of costs after the age of 14 if the glass thickness has changed by at least 0.5 diopters compared to the last prescription. Repair costs are covered by the health insurance companies.
For a time, the cost of plastic glasses was only borne by preschoolers. With a resolution of October 16, 2008, however, the Federal Joint Committee , the highest body of joint self-administration in the German health care system , revised the Medical Aids Directive to improve the care of children with visual aids at the expense of statutory health insurance. In the resolution, on the one hand, the exclusion of trifocal glasses , varifocals and high refractive lenses was largely abolished and adjusted to market requirements. In addition, plastic glasses can now also be prescribed beyond preschool age for low-grade ametropia.
Private health insurances (PKV) also offer various offers to cover the (additional) costs of children's glasses.
Switzerland
In Switzerland, the costs for spectacle lenses were covered by the mandatory health insurance until 2010 in the amount of a fixed unit amount . After the Swiss Federal Office of Public Health (BAG) canceled the assumption of costs with the entry into force of the Means and Items List (MiGeL) on January 1, 2011, spectacles and contact lenses will again be available from July 2012 for patients up to the age of 18 at an annual rate of CHF 180.00 . This rule is initially valid until December 31, 2013.
Austria
In Austria glasses fall under the so-called therapeutic aids . Certain additional payments for glasses are covered by the regional health insurance funds (GKK) if these are higher than 60% of the maximum contribution basis for the calendar day (2005: EUR 72.60). Children up to the age of 15 do not have to share costs; for children over 15 years of age, there is a minimum share of 20% of the maximum contribution base. Trifocal and varifocal glasses are not allowed to be paid for by the statutory health insurance.
Disposal of glasses
Especially with children's glasses, the useful life is limited by body growth and wear and tear. Children's glasses that are no longer worn can be disposed of with household waste, as the materials used do not contain any harmful substances. Alternatively, they can be given to an optician, who forwards them as a donation , for example . In Germany alone, the Central Association of Opticians (ZVA) collects around 35,000 to 40,000 glasses that are no longer used for third world countries , including numerous children's glasses . Many national and international aid organizations have initiated corresponding projects to enable poorer sections of the population around the world to be better supplied with all types of visual aids.
Trivia
The glasses are also known colloquially as a nose bike .
swell
- Children's glasses. Information brochure of the Professional Association of Ophthalmologists in Germany (BVA) and the German Ophthalmological Society (DOG) (PDF; 315 kB)
- Baby and children's glasses. Good Seeing Board of Trustees (KGS)
- Patient information ( memento of October 28, 2006 in the Internet Archive ) on children's glasses. University Eye Clinic of the Justus Liebig University, Giessen
- Press release of the Federal Joint Committee of October 16, 2008 on the improvement of supply services for children's glasses
- Information from the Federal Center for Health Education (BZgA) on visual impairment and risks in childhood
literature
- Bernhard Lachenmayr, Annemarie Buser: eye, glasses, refraction. Schober course: understand, learn, apply. Georg Thieme Verlag, Stuttgart et al. 2006, ISBN 3-13-139554-0 .
- Pamela F. Gallin: Pediatric Ophthalmology. A clinical guide. Thieme, New York NY et al. 2000, ISBN 0-86577-768-3 .
Web links
- Recognize visual disturbances and risks at an early stage - kindergesundheit-info.de: independent information service of the Federal Center for Health Education (BZgA)
Individual evidence
- ↑ a b c Direct health insurance - Statutory catalog of benefits
- ↑ a b c d e f g h i j k l m n o p Information from the Professional Association of Ophthalmologists in Germany - Children's Glasses ( Memento of the original from July 5, 2010 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 315 kB)
- ↑ a b c Patient information ( memento of October 28, 2006 in the Internet Archive ) of the Giessen University Eye Clinic
- ↑ a b c d e f g h i j Board of Trustees Good Seeing - Baby and Children's Glasses ( Memento of the original from March 6, 2010 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ a b c d Herbert Kaufmann (Ed.): Strabismus. 3rd, fundamentally revised and expanded edition. Georg Thieme, Stuttgart et al. 2004, ISBN 3-131-29723-9 .
- ↑ a b Federal Center for Health Education (BZgA) on visual impairment and risks in childhood
- ↑ Guidelines ( memento of October 19, 2010 in the Internet Archive ) of the Federal Association of Ophthalmologists in Germany (BVA), Appendix: Recommendation on the optical correction of refraction errors
- ↑ a b Guidelines 26b ( memento from October 19, 2010 in the Internet Archive ) of the Federal Association of Ophthalmologists in Germany (BVA), non-paretic squint
- ^ A b Pamela F. Gallin: Pediatric Ophthalmology. 2000.
- ↑ Bernhard Lachenmayr, Annemarie Buser: Eye, Glasses, Refraction. Schober course: understand, learn, apply. 4th, revised edition. Thieme, Stuttgart et al. 2006, ISBN 3-13-139554-0 , p. 118, online here .
- ↑ Quality regulations in the optician trade. Beuth-Verlag (DIN), edition 1961-12
- ↑ Federal Joint Committee decides on the revision of the Medical Aids Directive ( Memento of the original from January 5, 2010 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Means and objects list (MiGeL), as of: January 1, 2011 ( Memento of the original from December 4, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Swiss Federal Office of Public Health FOPH
- ↑ Page no longer available , search in web archives: List of resources and objects (MiGeL), as of July 1, 2012 Swiss Federal Office of Public Health FOPH
- ↑ Information on the health reform 2005 ( Memento of the original from March 30, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 72 kB) Vienna Chamber of Labor
- ↑ Information from the Central Association of Opticians in Germany ( Memento of the original dated November 12, 2009 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Eyewear collection campaign "Lunettes sans Frontiere" - Glasses without borders ( Memento of the original from January 11, 2010 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Information from the German Aid for the Blind ( Memento of the original from July 27, 2009 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Source: Duden - German Universal Dictionary
