This article will explore the issues surrounding the developing facial anatomy of a child and why a small adults frame is rarely successful in dispensing the correction. Facial measurements will be considered, giving hints and tips on how to measure or estimate in certain circumstances, and also how these facial measurements and characteristics translate into spectacle frame requirements.

We will look at ethnicity and Down’s syndrome and consider what impact this can have on facial characteristics and hence frame dispensing. Consideration will be given to the challenges of paediatric dispensing and suggested ways of managing the process along with hints and tips on possible modifications.