Eye glasses for babies and toddlers

• Eye glasses are also known as spectacles, made up of the spectacle frame and spectacle lenses.
• Babies and toddlers need to wear spectacles full-time as they are typically prescribed for significant vision conditions than can influence eye and brain development.
• Ensure that the frame you pick for your baby is comfortable and fits well.
• Single vision lenses tend to be prescribed to babies and toddlers to correct their vision.
• Often the full prescription is not given to your baby or toddler to allow for normal eye growth.

Spectacles are a simple and non-invasive way to correct your child’s blurred eyesight. But for the first time wearer, selecting the right pair of glasses can be a daunting experience. 

The term 'glasses' is used commonly to describe the combination of spectacle frames and spectacle lenses. This article describes important information about both.

Spectacle frames are the physical holder for corrective lenses, which must fit comfortably and accurately on a child's nose and ears to give them good vision.

Spectacle lenses are the key component of glasses which correct vision.

Babies and young children up to school-age can need to wear glasses if they have a high prescription for glasses such as myopia (short-sightedness), hyperopia (long-sightedness) or astigmatism. Without the glasses, the eyes don't see clearly and the brain doesn't learn how to receive clear information from the eyes for processing. If the eyes and brain don't learn to work together with clear information, this can lead to permanent impairment of vision.

Other vision problems in very young children which require full-time wear of glasses include amblyopia (lazy eye) or strabismus (turned eye).¹

Picking a spectacle frame for your baby or toddler is very important, to make sure the glasses are as comfortable and secure as possible for full time wear. The frame should be:

• Comfortable
• Sit well on the face
• Stay in place.

In order to achieve this, there are three important considerations - size, material and fitting.

1. Size: The frame should reflect the size of the baby or toddler's face and not be too big, otherwise it will continually slip off their head. Pick something that is similar in width to the widest part of their head, so pressure is not put on the their temples.
2. Material: Soft plastic or silicone frames for babies can be comfortable, durable and also avoid pressure on the skull bones, which are still developing until age 9-18 months.²
3. Fitting: The nose bridge and arms (temples) of your baby or toddler's new pair of spectacles should fit them securely. The bridge (part between the lenses) should be wide enough to fit their nose. The arms (temples) of the frame should also be long enough to sit behind the ears without pulling the ears forward. The bend in the temples, behind the ears, can often be adjusted by an optical dispenser, but the frame bridge size and temple length cannot.

Myopia in babies and toddlers is unusual and more commonly tends to onset in the early school years. The fastest progression (or worsening) of myopia tends to occur from ages 7-10 years.³ This means that a lot of research on understanding myopia progression and treatments is focussed on this age range.

Myopia in children younger than this can be associated with other general health syndromes,⁴ especially if it is high myopia. Often this requires the involvement of eye care practitioners such as an optometrist and/or ophthalmologist, and also paediatrician, to manage eye health as well as general health.

Babies and toddlers with myopia will typically have their blurred vision corrected with spectacles, and their visual development and eye health monitored. Myopia control treatments may be typically commenced from age 4-6, as this is where the evidence starts to exist for the safety, tolerance and effectiveness of the treatments.

For babies and toddlers, single vision spectacle lenses are generally prescribed. In children under age 4 with myopia, optometrists or eye doctors may prescribe lenses that are slightly under-corrected, meaning the full prescription may not be given. This is to account for the typical amount of healthy eye growth which is important to account for in the first few years of life. Normally full correction is given to children with myopia after age 4.¹

Once a child reaches age 4 and beyond, their myopia should be fully corrected and worn full-time. Unfortunately, many parents can request under-corrected or weaker glasses for their children with myopia, thinking that this helps their eyes 'be stronger'. The opposite is true: weak glasses make it harder for a child to function and research shows that they can actually speed up myopia progression.⁵

Myopia control is defined as using treatments to slow down the typical progression, or worsening, of myopia in children. Treatments include special types of spectacles, contact lenses or atropine eye drops. Standard types of spectacles and contact lenses, called single vision, do not slow down myopia progression.⁶

There are special types of myopia control spectacles which can slow down myopia progression in children, but these have only been studied from ages 6 to 8 and onwards. Starting wear of myopia control spectacle lenses before this age may still be possible. These lenses may work well for your younger child, but the expectations for treatment may need to be adjusted.

1. Leat SJ. To prescribe or not to prescribe? Guidelines for spectacle prescribing in infants and children. Clin Exp Optom. 2011 Nov;94(6):514-27. (link)
2. Bronfin DR. Misshapen heads in babies: position or pathology? Ochsner J. 2001 Oct;3(4):191-9. (link)
3. Tricard D, Marillet S, Ingrand P, Bullimore MA, Bourne RRA, Leveziel N. Progression of myopia in children and teenagers: a nationwide longitudinal study. Br J Ophthalmol. 2021 Mar 12:bjophthalmol-2020-318256. (link)
4. Marr JE, Halliwell-Ewen J, Fisher B, Soler L, Ainsworth JR. Associations of high myopia in childhood. Eye (Lond). 2001 Feb;15(Pt 1):70-4. (link)
5. Logan NS, Wolffsohn JS. Role of un-correction, under-correction and over-correction of myopia as a strategy for slowing myopic progression. Clin Exp Optom. 2020 Mar;103(2):133-137. (link)
6. Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci. 2019 Feb 28;60(3):M184-M203. (link)