What Parents Are Missing Is a Record
Ask parents what their child’s prescription is now, and most can give a rough answer: “Last year it was a little over -2.00, I think, and this year it went up a bit more.” Ask a little further (how much higher, which month it started changing, whether both eyes changed together) and the conversation usually stops there. Some prescription slips are tucked away in a drawer, some are photos somewhere in a phone album. Each one was measured at a different time in a different place, and even laid out on a table, they don’t line up.
What parents are missing isn’t concern. It’s a record that can be compared from one visit to the next. A prescription measured once is just a single point; only when several points are lined up in time order do they form a line. With that line, you can see which stretch your child changed quickly and which stretch barely moved.
The years when this line most needs to be recorded without gaps are exactly elementary school through junior high. In the Health Promotion Administration (HPA)‘s 2017 Child and Adolescent Vision Monitoring Survey, myopia prevalence climbed from 19.8% in first grade to 89.3% in the third year of junior high. Children’s myopia tracking at our Xinzhuang store means measuring the same items at regular intervals through these years and entering them into the same record.
Before Tracking Starts: The First Visit Is to an Ophthalmologist
If your child has never had glasses, the first stop is an ophthalmologist. This order is set by law, and an optometry clinic cannot skip it.
Rules for a First Eye Exam and Glasses at Ages 6–15
Under Article 12 of the Optometrists Act, optometry staff may not perform refraction on children under 6; they should be examined by an ophthalmologist. Refraction for children aged 6 to 15 must be carried out under an ophthalmologist’s guidance. Article 6 of the Enforcement Rules of the Optometrists Act is more specific: for a child aged 6 to 15 having their first refraction and glasses, a physician must first confirm that the myopia is not pseudomyopia.
So on your first visit to our Xinzhuang store, please bring the ophthalmologist’s diagnosis. Children who have already been diagnosed by an ophthalmologist and have had glasses fitted can start tracking right away; refraction for children aged 15 and under continues to be carried out under an ophthalmologist’s guidance from then on.
What Children’s Myopia Tracking at Our Xinzhuang Store Includes
On the first visit, our optometry staff set up baseline data for your child’s prescription and binocular vision; this first visit takes about 60 minutes. On each return visit after that, we measure the same few things and compare the numbers side by side with the previous visit.
Visual Acuity and Binocular Vision
At every return visit, our optometry staff check which line your child can read with their glasses on, that is, their corrected visual acuity, and carry out a binocular vision assessment: whether both eyes can aim at the same point together, focus together, and work well as a pair at near. Both of our stores do this at every visit, and the results go into the same record as the prescription.
Myopia is mostly a matter of the eye’s front-to-back length, the axial length, growing too long, so that light comes to a focus in front of the retina, and once it has lengthened it doesn’t shrink back. Axial length is an examination performed by ophthalmologists; our stores do not measure it. If your child’s axial length needs to be tracked, please have an ophthalmologist arrange it.
Prescription Recorded After Accommodation Has Relaxed
Children have strong accommodation. After a long stretch of near work, the ciliary muscle that handles focusing is still tensed, and an autorefractor reading taken at that point often comes out too strong. Fitting glasses to a too-strong number means overcorrecting.
Our optometry staff first help your child’s accommodation relax, then perform objective and subjective refraction. Only the prescription measured this way goes into the record, and the glasses prescription is updated to match the latest measurement. Cycloplegic (dilated) refraction is a medical procedure; if it’s needed, it is performed by an ophthalmologist.
Frame Position and Optical Center Check
Kids wear their glasses to and from school, playing ball, and napping face-down on their desks, so bent frames and nose pads pushed out of place are normal. The optical center of each lens needs to line up with your child’s eye; once the frame is crooked, the point they look through shifts as well.
For each return visit, please have your child wear their everyday glasses. Our optometry staff check whether the frame is bent, whether the nose pads are pressing, and whether the optical centers still line up, and adjust things if needed. To learn about the designs of children’s lenses themselves, see the Children’s Myopia Tracking Complete Guide.
Referral to an Ophthalmologist When Something Is Unusual
If tracking turns up abnormal vision (for example, your child still can’t see clearly even with correction), or if parents want to learn about medical approaches such as medication, our optometry staff will help with a referral to an ophthalmologist in accordance with the Optometrists Act. This is where the records built up over earlier visits come in. The records are normally kept at the store; when you need to take them to an ophthalmologist, just let us know and we’ll issue them, so the physician sees more than that day’s single number.
Here is who handles what, in one table (the age limits and the line drawn around medical procedures follow Article 12 of the Optometrists Act):
| Item | Optometry staff (Xinzhuang store) | Ophthalmologist |
|---|---|---|
| Refraction for ages 6 and up (aged 15 and under: under an ophthalmologist’s guidance) | Yes | Yes |
| Axial length measurement | Not performed; it is an ophthalmology examination | Responsible |
| Regular tracking records | Yes | Yes |
| Confirming not pseudomyopia before the first glasses at ages 6–15 | No | Responsible |
| Cycloplegic refraction, fundus examination | No, these are medical procedures | Responsible |
| Medication such as low-dose atropine | No, this is prescribed by an ophthalmologist | Responsible |
How Often to Come Back: Scheduling the Tracking Interval
The interval is once every 3 to 6 months. Which end of that range your child falls at depends on how they changed over the previous visits, and on the ophthalmologist’s advice.
The easiest schedule to remember follows the school year: once during winter break and once during summer break, which is exactly six months apart. If visits need to be closer together, add one in the middle of the semester. Coming back to the same place each time and being measured the same way removes one variable when comparing the numbers.
For children already diagnosed by an ophthalmologist who are ready to start a record, book at our Xinzhuang store: Beyond Visual Optometry Xinzhuang store (Biyang Optometry Clinic), No. 419-1, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, +886-2-2206-6700, book online.
If Something Comes Up Between Tracking Visits
Tracking happens on a schedule, but eye problems don’t wait for the date. If any of the following happens, take your child straight to an ophthalmologist:
- Between visits, your child suddenly says they can’t see clearly, or things look warped or distorted
- Red, painful, or light-sensitive eyes, or an eye that has been hit or injured
- You notice that one of your child’s eyes seems to turn inward or outward
- You want to learn about eye drops (such as low-dose atropine); these are prescribed by an ophthalmologist, so please consult one
However Careful the Tracking, the Prescription Will Still Change
The record itself won’t make the prescription stop changing; your child’s prescription will still change as it’s going to. What our Xinzhuang store can offer is letting those changes be seen a little earlier. Whether to intervene medically, and how, is decided by an ophthalmologist; we don’t provide treatment.
Xinzhuang Children’s Myopia Tracking FAQ
Q: At what age can my child start myopia tracking at the Xinzhuang store?
Once they turn 6. Under Article 12 of the Optometrists Act, optometry staff may not perform refraction on children under 6; they should be examined by an ophthalmologist. Refraction for children aged 6 to 15 must be carried out under an ophthalmologist’s guidance, and under Article 6 of the Enforcement Rules, a physician must first confirm the myopia is not pseudomyopia before the first refraction and glasses. Children already diagnosed by an ophthalmologist and fitted with glasses can come to our Xinzhuang store to set up a baseline record of prescription and binocular vision, then return every 3 to 6 months for tracking.
Q: My child is already using eye drops from an ophthalmologist. Do they still need prescription measurements at an optometry clinic?
Eye drops are prescribed by an ophthalmologist, so follow-up visits during the medication period, and what gets checked (including axial length), should follow the ophthalmologist’s plan. An optometry clinic does something different: it regularly measures the prescription after accommodation has relaxed, assesses binocular vision, records the results, and updates the glasses prescription to match the latest measurement. The two don’t conflict. If needed, the optometry clinic’s records can be issued to parents to take to the ophthalmologist for reference.
Q: Until what age should children’s myopia tracking continue?
Usually until around 18 to 20, when axial development levels off. Stopping partway through the growth years leaves a gap in the record, and later measurements are missing the earlier points they could be compared against.
Q: Besides regular tracking visits, what can parents do at home?
The HPA recommends that children spend 120 minutes outdoors every day. Outdoor time and visual habits can only be looked after at home; glasses can’t help with this part. At each return visit, our optometry staff will also talk with you about your child’s visual habits over the past few months, and any changes can be noted down together.
That stack of mismatched prescription slips in the drawer can become a line, starting with the next visit. On the first visit, remember to bring the ophthalmologist’s diagnosis with you.