Evidence-based spectacle prescribing for infants and children

Prescribing for refractive errors in infants and young children often presents a greater challenge to the optometrist than in the case of older children and adults. However, spectacle prescribing takes on a very important role in this age group since it can impact visual development. On the one hand, spectacle treatment when properly prescribed can reduce the risk of strabismus and amblyopia and enhance visual development. However, on the other hand, overly aggressive spectacle treatment may impair self-correcting processes (emmetropization) serving to reduce refractive error in the early years of life. Proper prescribing for infants and children must be rooted in an evidence-based approach. This article identifies the current evidence from basic research in ocular development as well as the results from clinical trials pertaining to the outcomes of early spectacle interventions. From this evidence, age specific guidelines are developed.