Trevor Miranda The Kids Category From Afterthought to Growth Engine

Children’s eyewear and myopia management have become one of the most dynamic and profitable areas in modern optometry.

Twenty or thirty years ago, the children’s category in most optical practices was often treated as an afterthought. Kids’ eyewear was typically displayed in a small corner with limited frame options, basic lenses, and very little focus on style, technology, or experience. It was often seen as a lower-margin category where the goal was simply to get a child into a functional pair of glasses and move on.

Today, that could not be further from the truth.

A Category Transformed

The children’s eyewear category has evolved into one of the most exciting, clinically important, and relationship-driven areas of optometry. In many practices, it has become a major driver of growth, patient loyalty, and long-term profitability.

One of the biggest shifts has been how children themselves view eyewear. Years ago, many children would cry when told they needed glasses. Today, many cry when they are told they do not need them. Glasses have become more socially accepted, more fashionable, and in some cases even aspirational. Kids see eyewear as part of their identity. They want frames that reflect their personality, interests, favourite colours, or even the social media trends they follow.

That shift has driven major innovation in frame design. Today’s pediatric frames are lighter, more durable, more flexible, and far more stylish than they used to be. We now have options with memory metals, spring hinges, silicone components, sports-specific designs, and frame geometries that better fit smaller faces and developing nasal bridges. The result is a better patient experience, improved comfort, and better compliance.

Better Lenses, Better Experiences

Lens technology has also changed dramatically. Children are no longer limited to basic plastic lenses. Parents are increasingly interested in premium lens options such as impact-resistant materials, anti-reflective coatings, blue light filters, photochromic lenses, and digital lens designs.
For active kids, second pairs for sports, sunwear, or outdoor activities are becoming increasingly common. In many cases, these upgrades improve not only the child’s visual experience but also the practice’s average revenue per patient.

Myopia Management Changes the Conversation

Of course, perhaps the most significant development in pediatric eye care has been the rise of myopia management.

For years, childhood myopia was approached with a relatively simple model: the child became more nearsighted, we prescribed stronger glasses, and we waited until next year. Today, we know that progressive myopia is not just an inconvenience. It is a long-term eye health issue associated with higher risks of retinal detachment, glaucoma, myopic maculopathy, and cataracts later in life.

That knowledge has transformed pediatric eye care from a transactional visit into a long-term care relationship.

Modern myopia management now includes options such as orthokeratology, soft multifocal contact lenses, low-dose atropine, specialty spectacle lenses, and increasingly, axial length measurement to monitor progression more precisely. We are no longer simply correcting blurred vision. We are actively trying to slow progression and protect long-term eye health.

That creates a very different type of conversation with families. Parents are often highly motivated when they understand the long-term implications of progressive myopia. It also creates a recurring care model with regular follow-up visits, imaging, testing, treatment adjustments, and ongoing education.

A Meaningful Business Opportunity

From a business standpoint, this is one of the most important opportunities in modern optometry.

Myopia management programs create recurring revenue, stronger patient retention, increased capture rate, and multi-year family relationships. A child enrolled in a myopia program often returns several times per year, may purchase glasses and contact lenses, may require sports eyewear or sunglasses, and often brings siblings and parents into the practice as well.

The profitability opportunities in the children’s category extend well beyond the first pair of glasses. Premium coatings, warranties, second-pair promotions, contact lenses, subscription-style myopia management plans, and family referrals all contribute to growth. Perhaps most importantly, pediatric patients often become lifelong patients. A child who starts in your practice at age six may still be seeing you at age 26.

That is why the children’s category should never be viewed as low value.

Optometry Becomes “Medical Retail”

In many ways, this is where optometry truly becomes “medical retail.” We are not selling. We are presenting opportunities, educating families, and allowing them to decide what is best for their child. When handled ethically and collaboratively, that creates trust, loyalty, and better outcomes.

The Next Phase of Pediatric Eyewear

Looking ahead, the future of the category is incredibly exciting. We will likely see more wearable technology, smarter lenses, AI-driven monitoring tools, personalized frame design, and even more advanced approaches to myopia care. The practices that embrace these changes early will be well positioned to grow.

Children’s eyewear is no longer a side category. Remember also that each child is often accompanied by a parent that may be present opportunity to update their own eyewear and ensure they have had a recent eye examination. It is one of the strongest engines for clinical impact, patient loyalty, and profitability in the modern practice.

2024 Trevor Miranda

DR. TREVOR MIRANDA

Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.


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Jade Bodzasy Pivot to Patience July-August 2026

When a child arrives for pre-testing already in a state of “high alert”, whether it’s a full-blown tantrum, silent freezing, or vibrating with anxiety, the clinical data usually becomes secondary to emotional regulation. If you try to force a measurement now, the “noise” from their stress will likely yield inaccurate results anyway.

Here is how to apply EQ to de-escalate the situation and salvage the appointment.

  1. The “Neutrality” Reset

When a child is elevated, the environment often becomes high-decibel and high-stress. As the professional, your first move is to introduce Neutrality.

  • Lower the Volume: Speak at a volume just above a whisper. This forces the child to quiet down to hear you and breaks the cycle of “shouting over” the noise.
  • Minimize the Audience: If the pre-test room is crowded or visible to the waiting area, close the door or move to a quieter corner. Reducing sensory input is the fastest way to lower cortisol.
  1. Narrative Labeling (The “I See You” Technique)

High EQ doesn’t mean “fixing” the emotion; it means acknowledging it. Children often escalate because they feel misunderstood or out of control.

  • Acknowledge the Feeling: Instead of saying “Don’t be scared,” try: “It looks like you’re feeling really overwhelmed right now. This room has a lot of big machines and that can be a lot for anyone. What should we do to help your body calm down?”
  • Give Permission: Tell them it is okay to be nervous. By removing the pressure to “be brave,” you often remove the resistance.
  1. Tactical Agency: Give Them the “Off” Switch

Anxiety is rooted in a lack of control. To get the data you need, you have to give some power back to the child.

  • The “Stop” Signal: Give them a physical signal (like raising a hand) that means you will stop the test immediately. When they know they have an “exit,” they are far more likely to stay in the chair.
  • The Choice Illusion: Ask, “Do you want to do the ‘balloon machine’ (autorefractor) first, or should we take the ‘eyeball picture’ (fundus photo)?” The order doesn’t matter to your data, but it matters immensely to their sense of autonomy.
  1. Utilization of “Collaborators”

In these moments, the parent is your most important Collaborator.

  • Indirectly regulate the Parent: If the parent is frustrated or embarrassed by the child’s behavior, it will escalate the child. Calmly tell the child, so that the parent can hear: “It’s okay, lots of people feel this way about this space. Let’s just give you a minute to calm your body. Maybe your parent could help show you how the chin rest works?”
  • Physical Grounding: If the child is small, have them sit on the parent’s lap for the pre-testing. The physical proximity to their “safe person” can calm them down enough to get a good reading.
  1. The “Pivot” Strategy

Sometimes, the EQ move is knowing when to stop. If you have tried de-escalation for five minutes and the child is still in a “fight or flight” state, pushing forward will only create a traumatic association with eye care.

  • Reschedule with Intent: Pivot the conversation. “I can see today is a big day for your eyes. Why don’t we try one small thing, and then we’ll save the rest for another visit when you’re feeling more like a scientist?”
  • The “Win” Ending: Always end on a successful note, even if it’s just the child successfully sitting in the chair for five seconds. Give the sticker anyway. You are “playing the long game” for their future eye health.

 

Summary for the Team

When a child is elevated, your job title shifts from Technician to Regulator. By focusing on their emotional safety first, you aren’t “wasting time”, you are ensuring that when you finally do get that measurement, it is accurate, and the patient is willing to come back next year.

Want to learn more about Emotional Intelligence, find more resources at www.emotionalintelligenceconsultinginc.com

 

Jade Bodzasy

Jade Bodzasy

Jade Bodzasy, Founder of Emotional Intelligence Consulting Inc., is a dedicated Coach and Consultant for Optometric Practices. Her extensive background includes over 20,000 hours of expertise focused on customer relations, work structure refinement, training method development, and fostering improved work culture within Optometric practices.

Certified in Rational Emotive Behavior Techniques (REBT), Jade possesses a unique skillset that empowers individuals to gain profound insights into the origins of their behaviors, as well as those of others. Leveraging her certification, she equips optometry practices with invaluable resources and expert guidance to establish and sustain a positive, healthful, and productive work environment.


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Diana Monea Children The Hidden Treasure

Practitioners who focus on pediatric eye care can drive lasting practice growth by prioritizing children’s vision, treating children as an essential yet often overlooked source of continuity, personal achievement, and gratification.

Vision is vital for a child’s development and education. About 80% of learning is visual, so even minor vision issues can hinder school performance and self-esteem. Teachers frequently request vision checks when students struggle, showing the importance of eye care in learning.

Lessons from the Real World

Over 50 years, my team and I managed three Eye Health Centres. A constant lesson we have learned is that children build practices. When children trust us, families return. Parents value their child’s care, which creates relationships over generations. Pediatric care gives lasting practice growth through relationships, unlike short-term marketing. Each appointment is a chance to teach families about the importance of eye health, and educating parents is key. Many people do not know that vision cannot be replaced at any price and that hidden eye issues, not obvious to the parent or child, can affect learning and confidence. Explaining vision’s role in a child’s development helps parents see the value of a comprehensive eye health exam.

Discussing with parents the impact of vision and the role genetics plays also increases engagement and adult referrals. When parents see eye health as essential to their child’s development and understand that vision changes as a child grows, they become long-term and consistent advocates for routine care. Educating families about the benefits of regular eye care not only benefits children but also practices by deepening trust and creating lasting loyalty. Soon, annual exams become part of a continuous health care plan for life.

Connecting Through Clear Direct Communication

Proper communication is essential when addressing children. It is important to communicate directly with children using simple terms. Effective pediatric communication means engaging children in their own treatment, not just addressing the parents. For example, instead of “We need to patch the eye,” say, “We cover your stronger eye, so the weaker one gets stronger. Do you see this eye doesn’t see as well?” Even young kids understand simple explanations. When they know why treatment matters, they feel less anxious and have fun in making their “broken” eye see better. Such engagement boosts cooperation.

You may then ask children about their favourite colour, advising the optician in front of the child about the colour and asking to see the child when they have selected the glasses. Such interaction increases child compliance and impresses parents, which builds positive rapport – everyone wants to come back because they are treated “special.”  When children and even adults feel noticed, they cooperate and eagerly want to come back.

These instances build practice success. Happy children make the experience positive and encourage trust. When kids enjoy the clinic, parents return, improving retention and reputation.

The clinic environment matters. A friendly environment turns routine care into memorable visits. Positive experiences encourage children to follow treatment, improving results and trust.

Children who grow up receiving consistent eye care often return as adults and bring their own children. This cycle strengthens the foundation of practice, creating enduring relationships over the course of decades.

Later, practitioners will see that generational continuity is a key factor in succession planning through “goodwill.” Word-of-mouth referrals from satisfied families remain the most powerful and cost-effective form of practice growth. Pediatric eye care is about forming lasting trust and relationships. Prioritizing children’s care is the central catalyst for sustainable, generational growth in practice.

Children are not only patients but also the essential treasure of practice builders, directly shaping lives and guaranteeing the success and longevity of eye care practices.

 

Dr. Diana Mae Monea, OD, FAAO, MHRM

Dr. Diana M. Monea, OD

Dr. Diana M. Monea is an award-winning optometrist, author, and keynote speaker with more than four decades of leadership in clinical practice, business ownership, and professional education. Founder and former CEO of Eye Health Centres, she now focuses on consulting, mentorship, patient care, and public speaking.


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