PALs and Children

[Dustin.B]

Afternoon everybody!

I have an inquiry of my vastly more experienced crowd today. I'm aware that children that require Add segments are always fitted into some form of lined bifocal, But what I'm dying to know is why? My current study material offers no solid reason as to the why a developing child couldn't adapt to a PAL. So please, what are your thoughts, knowledge, and experience on the subject?

Thanks in advance

~Dustin B.

[newguyaroundhere]

I am going to cite this article to help answer your question http://www.2020mag.com/ce/TTViewTest...essonId=111007


Usually when a child is given a Rx for multifocals, it is more for to help their eyes develop and continue working together and not so much for vision correction. In those situations, the child needs to have the full add power on them since a progressive lens will not give that to them unless they look all the way down the channel of the lens. Now, I have kids be fitted with progressive lenses but they were no younger than 8 or 9.

[uncut]

Afternoon everybody!

I have an inquiry of my vastly more experienced crowd today. I'm aware that children that require Add segments are always fitted into some form of lined bifocal, But what I'm dying to know is why? My current study material offers no solid reason as to the why a developing child couldn't adapt to a PAL. So please, what are your thoughts, knowledge, and experience on the subject?

Thanks in advance

~Dustin B.

Initially, cost was/is a factor. Multifocals are still a multiplicand of the cost of bifocals. Da newguyaroundhea.........also has part of the answers.

The fitting height of the add(usually pupil midpoint or higher) makes a short corridor multifocal the most desireable multifocal type, but, difficult for a child to discern the different power areas, and to use them correctly. Some adults can not comprehend "how to use a multifocal".
A child spends a lot of the day looking up at the world

[leeopt]

The reason for fitting a line so high is to force the child to engage the add, otherwise they will look over the segment. They tend to react to it as an obstacle not an aid. If you have an usually mature child that will listen, comprehend and accept the optical solution at hand as beneficial to their long termed visual needs then by all means us a progressive. Please excuse my sarcasm here...I'm middle aged but still a bit immature.

[Uncle Fester]

I believe it's usually to force convergence at near. Someone want to chime in with the medical terminologies?

[Robert Martellaro]

The reason for fitting a line so high is to force the child to engage the add, otherwise they will look over the segment.

Right. FT35s are recommended. Bisect the pupil.

I believe it's usually to force convergence at near. Someone want to chime in with the medical terminologies?

To treat convergence excess esotropia. Other conditions will probably not require a high fitted segmented multifocal. Consult with the prescriber.