Myopia control spectacle lenses, along with any type of spectacle refractive correction or intervention is only effective if the frame that holds the lenses is at the correct position in front of the eye and is both comfortable and safe for the wearer. For all patient groups being able to see clearly from an effective dispense is extremely important in daily life; however, for paediatric patients it is potentially life-changing as a successful intervention or correction can impact on their long-term vision, educational achievement, career opportunities and social development. The majority of paediatric frames are produced as a smaller version of an adult design and while they may hold cosmetic appeal with the use of designer brands and popular characters, the resultant fit is often far from satisfactory in terms of holding the lens in a stable and appropriate position as well as lacking the ability to physically adjust the frame to fit a child’s face. Achieving both stability and comfort from these small adult frames is unlikely as the parameters of a young child’s face are not that of a small adult. For example, from birth the wide, flat and relatively low position of the nasal bearing surface dictates the same wide, flat and low bridge requirements in a spectacle frame design. Dispensing a small adult frame results in the bridge sitting too high with little or no contact causing the frame to slide forward until it finds anchorage, usually at the nasal bulb. This element alone can cause the child to look over the top rim of their frames, an all-too-common sight.

This session will explore facial development and the various facial parameters that should be considered when designing spectacle frames for children based on a recent anthropometrical study where three-dimensional stereophotogrammetry was employed to capture images in a rapid, non-invasive manner. Fifteen paediatric facial measurements associated with spectacle frame parameters were measured using custom software in a sample of 1349 images of children observing differences in gender, ethnicity and Down syndrome.