The decision to prescribe glasses for a child is only the start.
The most common question I am asked on this topic is: "How am I going to persuade my child to wear glasses?"
Some children take to their glasses straight away and love wearing them. When that happens, it's great! However it is more common for a child to take a little while to get used to the glasses, and a few children are very reluctant to wear them. So what can we do to encourage a reluctant child?
Do the glasses fit?
The first step is to ensure that the glasses are comfortable and fit well. No-one can expect a child to tolerate glasses that dig into their nose or ears. One aspect of choosing glasses is often overlooked: lenses rubbing against eyelashes. Young children often have small noses, and some are blessed with long eyelashes. Unfortunately this can mean that the glasses press against the eyelashes, and stop a child opening his or her eyes! (Some children who deliberately wear their glasses halfway down their nose do so for this very reason - look carefully at their eyelashes before you tell them to push their glasses up their nose.)
Find the right frame
Be prepared to take time to find a frame that fits your child well. Curl sides and stretchy bands can be useful to keep glasses in place, but only for a child who is happy to wear glasses. If your child is reluctant, this will give her something to fight against, and make her less tolerant of the glasses. In this case, go for straight sides so that your child can easily take them off. I know that sounds counter-productive, but what you are aiming for is your child making an active choice to wear the glasses, and not feeling she is being forced to.
When to wear glasses
Next, make sure you understand what the glasses are for and when your child will benefit from wearing them (close work or TV for example). Only encourage wear for the right activity. If the glasses are designed to help straighten a squint, it may be that your child won't see any difference with them - it is important that you know this.
Take your time
Imagine what the world is going to look like to your child through the new glasses. The glasses may make the world much clearer. To you or me, that might mean "better", but to your child, it might simply mean "different". Many children with disabilities find new experiences difficult, and here we are changing how their world looks, so we need to proceed carefully. Some children, particularly those with autism, have problems with "Information overload". A clearer world through glasses will mean more information, and that might be intolerable. Limit the activities with glasses at first.
Adaptation programmes
Now, having thought about all of the above, you are ready to develop an "adaptation programme". Think of an activity your child enjoys, appropriate for the glasses: perhaps a favourite video if she is short sighted, a favourite book if she is long sighted, and during which she can have your undivided attention. You are going to make this a special "glasses wearing time". At the start of the activity, put your child's glasses on and help her to appreciate that she can see the activity better with the glasses. Keep the activity really short: there'll be plenty of time later to increase the length. If she takes the glasses off, immediately stop the activity (turn off the TV, close the book) without comment.
Build up glasses-wearing-time gradually
Day by day build up her tolerance, increase the time spent with the glasses on and introduce a second activity, and so on. Be prepared for it to take weeks or even months before your child is happy with the glasses. Above all, try not to become annoyed or frustrated and don't turn it into a battle - your child will win!
Reward behaviour
Some children hate glasses because they don't like anything in contact with their head. This time it's the physical contact with glasses that your child rejects, and she's not going to open her eyes to see that the activity looks better! You might need to try a different strategy, and accept just a second or two of glasses wear in the first instance. Make the reward for keeping the glasses on a huge vocal response from you or even a taste of favourite food.
Build tolerance
Try to anticipate your child's tolerance, and make sure that you take the glasses off for her before she has a chance to snatch them off herself. This way, you are trying to break the habit of the immediate reaction to the glasses, and help her to associate the glasses with a pleasant experience. Build up tolerance in very small steps.
Final steps
If everything looks like failing, talk to the optometrist or eye specialist who prescribed the glasses. Find out how essential they are and what the consequences are for your child if she never wears them. It may be that no harm will come to your child if you wait a while, and you can relax. If you have developed other tricks to persuade a child to wear glasses then please let me know - your experience could help others!
Maggie Woodhouse is a Senior Lecturer in special needs optometry at Cardiff University