The prescribing of spectacles for preschool children is very different from that for adults. Reasons for these differences include the inability to determine accurately a child's uncorrected and corrected visual acuity; as well as their lesser visual demands; their more proximal working distance; and their more plastic visual cortex, which places them at risk for amblyopia and strabismus. Most guidelines for spectacle treatment in such children are based upon clinical experience rather than randomized, masked clinical trials. Fortunately, the prescribing thresholds suggested by optometrists are quite similar to those suggested by pediatric ophthalmologists.