A young child's bridge is not developed yet, so it is often soft and fleshy. You will likely see impressions left on the nose just from the sheer weight of the glasses alone. As long as the impressions are even and go away shortly after the glasses are off, then they are of no consequence. However, if you notice the marks are deeper or redder on one side, or unevenly shaped, then adjustments will be necessary. Re-adjust the glasses until the impressions are even and disappear quickly once the glasses are removed. This may make the pads appear quite uneven on the frame. Never fear, this is because children's bridges often develop asymmetrically. This is something that simply can't be identified from the surface, but once the nose pads are introduced it will be revealed quickly.
Expect to see a light mark at the pressure point at the top of the ear. There needs to weight distributed to the top of the ears in order for the glasses to stay on, but it should not leave a deep ridge on the child's head, just a light impression. Again it is all about balance. Marks should be equal in size and darkness on both sides of the head. If you see a larger mark on one side of the glasses, try pulling the temple outward and re-evaluate. The marks at the top of the ear should also disappear within a few minutes of removing the glasses.
Once adjusted properly on the bridge and the tops of the ears, then look behind the ears. When adjusting the temples for a skull temple or a comfort cable, it is all about distributing the weight evenly over the entire length touching behind the ear. If a ridge is left anywhere behind the ear, it is too tight and should be re-adjusted. I love comfort cables for fitting here. They can be warmed up and molded to shape the back of the ear and hug along the side of the head. Once this adjustment is done, there are generally no marks left behind the ear at all.
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.