After the PD measurement, next up is a temple length measurement. Yes, you need to measure a temple length. You may be able to get away without measuring for it on your average adult, but not with a bouncing 2 year-old. Their glasses have to stay on and stay put not only for good vision, but also to prevent catastrophes like broken glasses that fell off and got tromped on in the ball pit at Chuck E. Cheese's.

I will assume you know how to measure for a skull temple, but for a cable adapter it is a little more complicated. When measuring for the cable adapter fitting, we measure from the screw or bend on the temple to the furthest curve on the ear. Again you may need to find your inner child to get them to cooperate. My daughter and I will often take turns acting like a "fool" to get the child to look in a certain direction while the other one measures.

Whether you are fitting the cable on a metal or a plastic-covered metal core, the beginning of the process is the same. I hold the cable adapter against the temple with one hand and use a ruler to measure the length that corresponds to the edge of the adapter. Use your ruler to measure from the inside of the cable up the temple to the bend or the screw. Slide the cable up or down until you get to the right spot behind the ear and make a mark on the temple. This mark is where the cable will begin, but not where you cut the temple. You should cut the temple about 10-15 mm longer to start.

If you have a plastic covered temple cut at the mark only through the plastic overlay and remove the covering. You can get a snug fit by flattening the end of the metal and warming the temple end so the cable adapter can ease into the fitting. Finish up by cooling it off with water after the cable is on. I always secure the cable adapters with gel control super-glue, but not until the patient comes in for the final fitting.

Fitting cable adapters on a frame can be a bit challenging, but every optician can do it and should do it. Cable adapters can be bought from companies like Hilco or Vigor and are a must in any pediatric optician's toolbox.

Danielle Crull, ABOM, owns A Child's Eyes, an independent optical store specializing in pediatrics in south central Pennsylvania. She became a Master Certified Optician in 1997, and her thesis topic concerned the differences between dispensing to children and adults. She lives in Dillsburg, Pa., with her husband and three children, all of whom work in her business.