Understanding the child’s role can lead to long-term treatment success and build trust with patients.
May 15, 2025
By Ashley Tucker, OD, FAAO, FSLS, ABO Diplomate
In most clinics, a significant amount of time is spent discussing the benefits of myopia management with parents, while little attention is given to the thoughts and feelings of the actual patient – the child sitting in the exam chair. Yet, children today are more informed and perceptive than ever before. With constant access to television, YouTube and social media, kids are exposed to a wide range of information that can shape their understanding and perception of their own health.
It’s important to remember that children should not be passive participants in their care. They may already have questions, concerns or even misconceptions about their vision and treatment options. As eye care professionals, we should take the time to engage directly with our young patients—acknowledging their thoughts, addressing their fears and helping them understand the “why” behind the management plan.
By involving children in the conversation, we not only build trust, but we also improve compliance and treatment outcomes. After all, a child who feels seen, heard and empowered is far more likely to embrace the journey of myopia management.
For best success, the conversation must be tailored to each age group. I’ve outlined some sample conversation starters for ODs to consider when talking to pediatric patients about myopia management. I’ve also found that it’s helpful to ask parents’ permission to speak directly to their child – especially before offering contact lenses as an option. Being mindful of family dynamics and beliefs is imperative.
Age 7 and under
With the youngest age group, simplicity is key. It could be helpful to try something like this:
“As you grow, your eyes also grow. It is my job to protect them from growing too long. You and I are going to work together to make this happen.”
For most patients in this age group, we are managing pre-myopia or mild myopia. Thus, lifestyle changes are typically the prevailing topic of conversation. Ask the child about their sports, hobbies and interests, and incorporate their answers into ideas about howto get them outdoors. Also, discuss limitations for device usage and demonstrate an appropriate working distance by using their own arm. Planting seeds early on will hopefully lead to good, lifelong habits.
Age 8-12
This is the prime age to start discussing contact lenses. I’ll often start the conversation like this:
“How do you feel about wearing contact lenses – either at night or during the day – in order to slow or even prevent your vision from getting worse!?”
You can have an open conversation with most kids in this age group about the general pros and cons of contact lenses and the differences between each modality. Taking it one step further by allowing them to actually handle each lens type before committing to one is also very impactful. Once a decision is made, most kids exhibit a sense of pride and are excited to move forward with contact lenses. If not, pharmaceutical therapy is a good bridge to eventual contact lens wear.
Teenagers
Most kids this age can take full ownership, within reason, of this decision. They will likely possess enough maturity and foresight to recognize that myopia management will truly benefit them in the future. In fact, some teenagers will begin to express genuine concern and fear about the consequences of increasing myopia. In these cases, be sure to take a moment to reassure them. It can be helpful to say something like this:
“You are in the absolute best hands. I specialize in protecting vision. You can trust that I will do everything within my power to do just that for you.”
As practitioners, we should not underestimate children and their ability to make informed decisions for themselves. With that being said, there will certainly be times when both the practitioner and parents will have to override the child’s decision. However, at the very least, giving them an opportunity to be involved in the decision will build trust and rapport with the child for years to come.
