FOCUS ON KIDS' EYEWEAR

By Mark Mattison-Shupnick, ABOM

Release Date: September 15, 2016

Expiration Date: March 30, 2020

Learning Objectives:

Upon completion of this program, the participant should be able to:

1. Understand a current snapshot of the kids' eyewear market.
2. Learn what trends affect children's behaviors that affect their need for eyewear.
3. Understand key attributes of children's eyewear.
4. Learn how to communicate the right children's eyewear solutions.

Faculty/Editorial Board:

Mark Mattison-Shupnick, ABOM, is currently director of education for Jobson Medical Information LLC, has more than 40 years of experience as an optician, was senior staff member of SOLA International and is a frequent lecturer and trainer.

Credit Statement:
This course is approved for one (1) hour of CE credit by the American Board of Opticianry (ABO). Course STWJHI643-1

---

If I ask an audience of opticians to tell me the biggest issues when selling eyewear to kids, I often get two answers. The first is that it's the parents who are the problem, not the children; and two, selling eyewear to kids is too difficult. It turns out that with the right attitude and knowledge, selling eyewear to children is an untapped opportunity. If it's a wonderful result, how can you reduce the challenges of getting there?

THE CHILDREN'S MARKET

From the 2012 U.S. Census, there are about 60 million children in the U.S. today, 14 years and younger. That's about 20 million each for the age groups, less than 5 years of age, from 5 to 9 and 10 to 14 years of age. Each of the age groups under 14 has lots of eyewear and sun-wear opportunities.

In Canada, it's comparable. There are 5.6 million kids 14 and under or just under 17 percent of the population. The opportunities are the same.

It is estimated that globally, eyewear sales will grow. And the expansion of the wearer base will in part come from a focus on children, especially in emerging markets. Growth from $81 to $131 billion over seven years from 2011 to 2018 will make a lot of businesses happy. In this same research report from the Wall Street Journal (January 2014), it suggested that kids' eyewear sales have been growing 10 to 25 percent for the time period 2011 to 2013. That perhaps explains the overall 4 percent increase in unit sales (Vision-Watch, 12 Months Ending September 2013) for the same two-year period. Are you prepared to take advantage of this opportunity?

OPPORTUNITY DEFINED

From the Vision Council survey 2012 Parent Child Vision Care Report and from Vision-Watch data, children who have had their eyes examined in the past year were more likely than other children to wear some type of eye-wear, especially prescription eyeglasses. That means parents and every optical office should encourage kids exams.

Children who are covered by some type of insurance were also more likely to wear more than one form of vision correction, such as Rx eyeglasses and plano sunglasses. Therefore, be sure that every insurance patient is asked about his or her family, i.e., how many kids, when they last had their eyes examined, the importance of glare and UV protection, etc.

When looking at Rx eyeglass usage among children under the age of 18, significant differences in usage exist based on the age of the child. For instance, while 31 percent of children between the ages of 14 to 17 regularly wear Rx eyeglasses (five million children), only 11.4 percent of children under the age of 10 regularly wear Rx eyeglasses (4.8 million children). It suggests that younger kids are being missed.

In 2012, there was about 6.5 million pairs of eyeglasses sold for the under 14-year-old (3.5 million for the under 10 and about three million for the 10 to 13).

What can we say about that? When we talk to ECPs and parents, most say kids that need eyeglasses and have them are seen yearly. From the data, that's obviously not the case. Only about 70 percent of the kids wearing glasses in 2012 received a new pair of glasses, and it's actually lower than that because there were obviously kids that got glasses for the first time in that mix.

From the April 2013 20/20 Kids' Eyewear MarketPulse survey, 1 in 5, or 20 percent of the average optical business comes from kids, and it is estimated that contributes 15 percent of the gross revenue of the office. How can we understand the total opportunity?

From a 2009 Vision Council report "Making the Grade," it is estimated that 1 in 4 children have a vision problem that interferes with their ability to learn.

According to the National Eye Institute's Vision in Preschoolers study, there are several vision problems that are commonly found among school-age children. They are ambly-opia, or lazy eye, which affects 2 to 5 percent of preschoolers, and strabismus, in which eyes cross in or turn out, affect 3 to 4 percent. The study also found that 15 to 20 percent of preschoolers had significant refractive errors. If we add that together, we get 20 to 29 percent having vision problems, or about 1 in 4.

The question therefore is, "How many kids who need glasses don't have them?" If we assume that kids under 14 who need eyewear should get eyewear yearly, that suggests a 15 million kid opportunity.

In 2012, 3.5 million were purchased for the under 10-year-old, and 4 million for the 10- to 14-year-old; that's only half the kids that need them. There is an annual potential of another 7.5 million pairs or so at an ASP of about $160 or $1.2 billion with a "B" opportunity.

POOR VISION AND LEARNING, SCHOOL SCREENINGS, SUNWEAR

Nationally it is estimated that only 7 percent of kids have had a comprehensive eye exam by the start of first grade. Even more concerning was that only about half had an exam by high school graduation. Eighty percent of what children learn in their first 12 years comes through visual processing. There's a problem here.

There are many sources; the AOA, AAO, National Institutes of Health and others that have described how untreated impaired vision can affect the learning or cognitive, neurological and physical development of kids. Can't see well? How does it affect learning to read, riding a bike, running and ultimately self-esteem?

You probably also thought that all kids get screened for vision issues before starting school since good vision is expected to produce better results in students. It turns out that's not the case. From the "Making the Grade" report, there is great variability across the U.S., state by state, in what is required for children when entering school. According to the report: "As many as 80 percent of children who fail a vision screening do not receive a follow-up eye exam by an eye doctor as recommended." The statement says it all.

Let me give you an important fact about kids' eyes and their development by illustrating it with a question. What percentage of UV radiation is transmitted through the crystalline lens of kids 10 years and younger—75 percent, 60 percent, 35 percent or 10 percent? The answer is 75 percent.

It turns out that the lens in a kid's eyes at about 4 years is completely transparent to UV, i.e., the UV goes right through to the retina. By age 10, a protective chemistry is developing in the lens to absorb UV. By age 25, only about 10 percent gets to the retina. The body is designed to protect the retina from damage from UV radiation. UV causes the lens to turn yellow (a by-product of UVA absorption) or results in a cortical cataract (UVB). Because of the lens' initial transparency to UV, it is estimated that as much as 80 percent of the damage to the retina is done by age 21. Therefore, good quality, 100 percent UV-absorbing sunwear is essential for kids as well as over a lifetime.

Do you lather up your kids at the beach with sunscreen for play outdoors? From a VSP newsletter, 82 percent of parents require sunscreen today but that's not the case for sunwear. Only 32 percent of parents surveyed ensure that their child is wearing sunglasses when he/she is wearing sunscreen. Why is quality sunwear important for kids? Kids get three times the annual exposure. They spend more time outdoors, and small amounts of UV are accumulated over a lifetime.

Blue eyes are at more risk for UV damage than brown eyes. From an Essilor newsletter article: "Eye color is created by melanin, which also dictates skin color. The more melanin in your iris, the colored area surrounding the pupil, the darker your eye color will be. More melanin means better protection from the sun—the pigment in your eyes literally protects your retina. Light eyes such as blue, green or grey are more sensitive in sunlight. UV exposure over a lifetime can result in cataracts, pingueculae, pterygia, cancers and AMD. A 20-year delay would practically eliminate these diseases as significant causes of visual impairment in the United States." Therefore, it's simple: Sunwear for all children is required.

BEING OUTSIDE IS IMPORTANT

All kids would benefit from being outside to play (with the right sunwear, of course). However, there's more to it.

The trend in kids is for less time outdoors and instead on electronic devices. That means more focusing close up for longer periods of time. The scientific community agrees about the need to be outdoors. From studies to understand the alarming rise in nearsightedness in Singapore (about 60 percent of kids and 80 percent of adults are myopic), it's understood now that kids being outdoors and getting a good dose of sunlight is required for eye development. Sunlight outdoors produces dopamine, a chemical that retards the growth and lengthening of the eye that contributes to myopia. As a result, the government of Singapore started a public awareness program to get kids outdoors for better vision development.

Then, focusing for longer close up produces a "lock" of sorts. Focusing far away then takes time. Finally, most new electronic devices like smartphones and tablets emit blue-violet light (HEV), and it's the close up accumulated effects (AMD) that have the professional community concerned. If 52 percent of kids have access to a smartphone or tablet, and that number is increasing, what will be the longer-term effect of electronic devices from an indoor, focusing, digital eyestrain and damaging blue light perspective?

CHILDREN LIKE GLASSES

Dorothy Parker didn't know what she's talking about when it comes to "kids and four eyes." Four eyes ARE better than two. Harry Potter did wonders for round eyewear sales as kids in glasses wanted to emulate their favorite wizard. In fact, Halloween made eye-wear even more important with all the Harry Potter costumes worn. Eyewear is sometimes so sought after by kids that kids will fake it when being tested to get a pair of glasses like their parents or favorite hero.

MORE KIDS TO BE COVERED

The potential number of kids to be covered by 2018 is estimated at about 8.7 million. This is in part due to the dental and vision benefits written into the Affordable Care Act (ACA). The ACA requires insurance plans to offer pediatric services including vision services, through state health insurance exchanges, as one of the 10 required categories of essential health care benefits that began Jan. 1, 2014. In addition, EyeMed, VSP and other MVC programs have special coverage for children. Review the plans and ensure that all parents know what is available so that each child gets all that they need.

Now that we understand trends, issues and concerns, what can we do about it?

IT'S ALL ABOUT THE FRAME

First, kids love color, and that helps them choose the frame they WANT to wear. When kids want to wear their glasses, mom is happy, and the reason that they were prescribed glasses is fulfilled. Acetate is the solution for all those great colors, textures and combinations of design.

Next is fit, if the frame is uncomfortable, kids won't wear them. Therefore, consider that every frame is supplied with spring hinges for easier fitting, and they'll take a kid's everyday bumps, yet return to the right fitting position. For metal frames, adjustable nosepads ensure that the pads can match the shape of a developing nose. Each pad arm should be easily adjusted for position but a slightly stiffer pad arm retains its position longer. Soft silicone pads ensure that the frame sits firmly on the nose. All pads are attached with screws. That means that pads are more difficult to lose or remove; that makes them less edible for the smaller kids.

Companies like Luxottica subject all children's frames to the same stringent quality testing as adult frames. If they can be manhandled and survive, mom will be happier with the value received. Moreover, durability means that the prescription will work as it was intended.

Lastly, in each frame, there's more than a hint of adult design. In this way, modern trends like flat metals are delivered in a combination style, suggesting a cateye shape that is prescription-friendly, produced with a soft corner so that resulting prescriptions aren't overly thick. Mixed with features like fairy dust accented temple tips, this Princess frame produces adult as well as kid appeal. Meet with your reps, learn the company's descriptions and use those words with mom and child.

TALK TO EVERY MOM ABOUT SUNGLASSES AND KIDS

Unfortunately, not enough kids get the sunglasses that they should. However, there's good news in that when sunglasses are considered, most ECPs sell photochromics to protect a child's eyes indoors and out. A Jobson survey found that of the kids who wear Rx sunglasses, 72 percent wore photochromic lenses.

Having photochromic lenses meets mom's concerns about sun, cost, as well as potential loss. Photochromic lenses are so convenient for kids when carrying another pair of Rx sunglasses is impractical because of age. And photochromics are available in super impact resistant polycarbonate or Trivex material.

In fact, adding lens technology improvements like no-glare and photochromic lenses add to profitability. Depending on your lab, any MVC benefit and pricing, you can increase the average sell price an extra $75 to $100 per sale. Who benefits? The child benefits from the extra clarity of anti-reflective lenses and photochromic protection while wearing a lens that's fun when it changes tint outdoors. This encourages kids to wear them. Be sure that your schools understand photochromics (visit to review glare, UV and safety hazards that eye-wear can help), especially if they don't allow sunglasses on school grounds.

LENS SIZE, BUNDLING, NO-GLARE

Many lenses for kids require surfacing at the lab to deliver the best looking and right thinness given the smaller lens sizes required. Consider smaller lens sizes with rounded corners to reduce the effective diameter required. Larger EDs add thickness to any lens.

Consider bundling the lens and frame into a "Kid's Package." This makes it easier for mom and dad to understand the value of its component parts. It also can be directly compared to the costs if lenses, frames and treatments were purchased separately. Then provide a cost for a backup pair considering whether there are vision care benefits (EyeMed provides 40 percent off the second pair). Median pricing, reported in a survey by Jobson is $120 for frames, $100 for scratch-resistant lenses. Use that for comparison.

Lastly, add in no-glare lenses especially if 80 percent of learning is vision aided.

DO KIDS WANT BRANDS?

Absolutely, just like their parents use brands, kids develop brand interest early. From "Children's Understanding of Brand Symbolism" (University of Michigan), preschoolers recognize brand names and symbols and use them when choosing TV programming, toys, books and online choices. Both parents and kids make judgments about products based on associations with those brands. Think about a brand, outside of optical, to which you are loyal. You can probably list two or three reasons for that loyalty. What do you feel when you see the word "Disney" or the image of Mickey Mouse or Disney Princesses?

From Euromonitor, Mickey Mouse and Dis-ney are the best-known brands worldwide— what better way to attract children with an image of brands they and their parents know and trust.

Adults (parents) use branding to narrow choices, and their children learn by watching their parents. It's learned early. Disney supports the feelings of wholesome, imagination, good value and money well spent. Use brands to help sell eyewear to children.

COMMUNICATE THE OPPORTUNITY

Every point in the office should ask patients if they have children. That opens the dialogue to: "When were their eyes most recently examined? Do their glasses need adjusting? Can I answer questions about your child's (grandchild's, niece's) vision?"

If we have an underserved population of almost 7.5 million children, it's obvious. We don't ask often enough. Here are a few more questions: "Do you have children? How old? Have they had their eyes examined for vision needs? Did you know that 1 in 4 children have a potential vision need/problem?" And so on.

PLEASING THE PARENT

Address the warranty, durability and comfort qualities first—that's what every parent is interested in. Reprise the quality of the frame and the manufacturer's confidence in their product and the warranty. Discuss the perfect kid's lenses and your lab's expertise in assembling their pair of glasses. Comfort also means that the materials consider irritation and allergies, so have hypoallergenic options.

For every parent's child, describe how lenses are always 100 percent UV protective, far exceeding ordinary impact resistance requirements; your office only uses polycarbonate or Trivex material lenses.

The styling selection of frames is modern and takes advantage of the latest frame manufacturing technologies. This meets the parent's wants for contemporary, well-fitting and good-looking glasses. Finally, ask if you haven't yet, "What is most important to you as a parent?" Let the parent tell you their expectations and reiterate how you got to the solution for their child's eyewear.

PLEASING THE CHILD

Kids can be simpler. When kids are surveyed, colors and shape lead the list followed closely by brand. Manage the parent's wants with the child's so that both are met almost simultaneously.

Then, once the target frame(s) is identified, be sure it fits. For the child, they choose quick ly but if the frame doesn't actually fit well, the child won't wear it. That is a bigger problem and will require a frame change. Comfort is key. Moms know a lot about their kids so ask her, "What is most important to your child?"

PLEASING THE ECP

For the ECP, there is a combination of clinical, business and team requirements to be successful in selling kids eyewear. The growing kids market is an opportunity for differentiation and profitability if done right. The practice management organizations suggest that an average adult patient spends $25,000 in your office over their lifetime. Add in children, make more parents aware of critical kids' needs, and a family can triple that number. In addition, a well cared for child engenders loyalty. That's important since so many different businesses around you and online are trying to entice patients away.

Choose collections that provide frame answers for preschoolers, kids, tweens and teens as facial features develop. Remember that brands influence decisions and parents have concerns about durability and fit. Use the brand's identity to your benefit in shortening the decision process. Use the company's merchandising materials and the rep's expertise.

KEY POINTS TO REMEMBER

Kids are in focus—individuals, companies, the government and ECPs are more concerned than ever for their vision needs.

Be aware, electronics and behavioral changes require watching so stay tuned to articles in the trade press that highlight research and products that offer solutions. Quality sunwear makes a difference for kids immediately. Remember that the damage from UV and blue light HEV is accumulated so starting early works.

Kids are an opportunity; new frame and merchandising solutions can make every office successful. Teach the brand, color, fitting and profit opportunity. Practice, role-play and rehearse scripts for talking to mom and kids about lens/ frame combinations that provide excellent value because of all their inherent benefits.