Accommodating children with glaucoma

The add should be placed high enough to be engaged when the child performs near activities.

Typically, a D segment or executive-type bifocal is used.Progressive, or no-line, bifocals are cosmetically more appealing and often desired by the parents; however, the power required for good alignment is typically located too low in the smaller pediatric spectacles.As a result, this type of bifocal is often reserved for older children and teenagers who will seek out the area of greater plus power and be successful with them.Several studies have indicated that, unlike typical children who become less hyperopic with advancing age, children with accommodative esotropia generally develop increasing amounts of hyperopia until about age 7 followed by a gradual decrease thereafter.Periodic follow-up, approximately every 6 to 12 months, is necessary to manage the spectacles and monitor for amblyopia.

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