DISPENSING FOR PAEDIATRIC PATIENTS – PART 2

IN THE SECOND PART IN A SERIES ON DISPENSING FOR CHILDREN, ELIZABETH CASSIDY OUTLINES PRACTICAL TIPS, AND HOW THE STORE CAN BE DESIGNED TO ELEVATE THE EXPERIENCE FOR BOTH CHILD AND PARENT.

Part one of this series on paediatric dispensing tips focused on communication techniques and frame selection. Part two covers considerations for lenses, measurements and collection.

Lenses

With lenses for paediatric dispenses, impact resistance should be a priority. Even if the parent says their child takes care of their glasses, they will be around other kids who may not be as careful – and we want to reduce the possibility for injury.

Polycarbonate and Trivex are highly resistant materials and if kids fall over or have flying objects hit their glasses, the lens will stay in one piece.

At this stage, it’s common to be faced with conflicting needs from optical considerations, the child and the parent. Typically, these fall into four categories: Fashion – You may have a child or parent focused on the frame style. This is beneficial because kids are more likely to wear a frame they like. Remember, durability and fashion aren’t mutually exclusive.

Comfort – Children are unlikely to wear uncomfortable frames. Fortunately, modern frames and lenses are designed to be comfortable, as long as the frame dispensed is appropriate for the child’s anatomy.

Safety – This is a critical issue with impact resistance, but UV safety is especially important. Studies have shown up to 80% of an individual’s UV exposure occurs before the age of 18. In Australia, we’ve learned to be sun-safe, but the research shows only 32% of children are wearing sunglasses protection. In paediatric dispenses, photochromic lenses are the most common recommendation, as it reduces the need for the child to be swapping glasses.

Price – Some price-conscious parents may not wish to pay for the child’s first choice, or the highest quality lens. The duality of communication is essential here. As dispensers, we must ensure our customers are treated with respect and understanding, while giving quality care and advice.

Measurements

Taking measurements can be difficult with paediatrics, and I have seen a range of methods. Below are two specific measurements, pupillary distance (PD) and heights.

For older children, using a pupillometer is ideal, or an appropriate digital device. But for younger children or babies, the only option may be turning to the PD ruler. Here, we would be measuring from inner to outer canthus. This isn’t the most accurate method but is better than guessing where their PDs are. When frame selecting, choose one that ensures their PDs are as close to the geometric centres as possible. This helps to reduce extra unnecessary thickness, weight, aberrations, and will likely have a better fit.

Heights should also not be underestimated. Ideally, centre of rotation rule heights should be taken for single vision lenses, or if not possible, then having their eyes as close to the lens’ geometric centre will reduce the need to take this measurement. For bifocals, set the seg higher than normal – on pupil centre – so the child looks through the near seg when reading. Taking heights for very young children may be difficult, however a pre-marked demo lens or height gauge may be easier. This way you can observe the child over time, compared to getting them to stay still and focus.

Collection

On collection, as with any dispense, we should ensure the correct fit and the specs work as intended.

Humour and keeping the tone light and simple is a great start. Use rhymes, rules and questions to reinforce understanding.

Humour and a light tone can be useful upon collection to ensure the child remembers how to care for their spectacles.

Remember for many paediatric dispenses, this may be the first time, so don’t assume prior knowledge, and it’s useful to repeat to existing wearers. It is easy to forget in the business of dispensing that children can’t always explain how they feel or what they see. Be patient, allow them to speak up and ask questions. Parents often tell children to just get used to the glasses as they don’t know what could indicate a problem. Therefore take time to check all aspects of the glasses on collection.

Kids Corner

A special area of the store for paediatric dispenses can change the experience for both the child and parent, including a colourful display that has mirrors at different heights. Also consider parents may be coming in with multiple children, so a toy box can be helpful. Finally, small gifts such as balloons or stickers can brighten their mood, especially if they’re unhappy about needing specs.

Overall, paediatric dispenses require extra care, patience and kindness. But nothing beats having families return and request the same dispenser. Providing a special service is a good investment for the future and families will often recommend your service to close ones.

ABOUT THE AUTHOR: Elizabeth Cassidy, who started working in optics in 2015, is an optical trainer and compliance officer for the Australasian College of Optical Dispensing (ACOD). She has completed a Cert IV in optical dispensing and a Cert IV in Teaching and Assessing. She has worked at numerous practices across Australia, as a senior dispenser and training other staff.