RGP insights

Avoiding "The Parent Trap"

BY EDWARD S. BENNETT, OD, MSED
SEPTEMBER 1999

A 12-year-old girl visits your practice and indicates an interest in contact lenses. Before you have an opportunity to discuss all of her options, the child's mother announces that her daughter will be fit into soft contact lenses. The girl echoes this by saying that her friends wear soft lenses and they told her not to go into hard lenses because they hurt.

In this day and age, it's easy to be influenced by the parents and peers of your patients. Don't be. Although this trend will continue to escalate as more long-term soft contact lens wearers become parents, it's important to discuss the advantages and disadvantages of both RGPs and soft contact lenses before the patient makes a final decision.

Initially, it's important to acknowledge that soft lenses are easier to adapt to because of their size and the limited movement they exhibit on the eye. RGPs, conversely, don't feel the same way at first. They usually require a few weeks of wear to become totally comfortable. However, RGPs are high-quality custom lenses that typically result in excellent vision. By presenting both the patient and his parents with all of the options, you illustrate the concern that your practice has for his ocular health.

In addition, in a time when most parents are especially interested in reducing and managing myopia, it's good to discuss the fact that clinical studies have shown that RGPs have reduced the progression of myopia.

Fitting Facts

You can start fitting any form of contact lenses at an early age. Certainly between the ages of 9 and 12, most young people can handle and care for their own lenses. A child's level of motivation is the most significant factor in their ability to achieve success. If they have previously been a spectacle wearer and desire contact lenses for either sports or for vanity reasons, a successful outcome is likely, but if they are uncommunicative and don't respond positively to the idea of wearing contact lenses, talk to their parents. In this case, the parents may be the ones who desire contact lenses for their child, not the child himself. If this is true, then it may be best to wait until the young person is the one who desires them.

Because most young people are involved in some athletic activity, RGPs can be designed to exhibit minimum dislodgement, if any. A large diameter ( > 9.5mm), low-edge lift design should accomplish this task.

Remember that the presence of even small amounts of uncorrected refractive cylinder can affect eye-hand coordination, which could result in possible vision problems in sports such as baseball and basketball.

Don't Fall Prey

Fitting RGPs on young people often results in them staying in them and returning to your practice, which gives you a competitive advantage and enables the contact lens portion of your practice to grow. Don't ever assume that just because patients have a preconceived idea about which mode of lens wear they want that they will leave your office with that same modality. After discussing the pros and cons of both soft lenses and RGPs, you may be surprised by the results.

As information about the effect of RGPs on existing myopia and myopia progression becomes disseminated to the media, many more patients will be asking for them. Provide your patients with this information first by presenting this modality as a viable option. Most young people and their parents are interested in what's best for them and in most cases, it's RGP lenses.

Dr. Bennett is an associate professor of optometry at the University of Missouri-St. Louis and executive director of the RGP Lens Institute.