editor's perspective
Babies Need Contact Lenses, Too
BY JOSEPH T. BARR, OD, MS, FAAO, EDITOR

In the past few months, we've fitted two young aphakic children with high Dk scleral RGP contact lenses. Scleral lenses? I'm sure you're thinking, "You must be kidding." But I am not joking. Once the pediatric ophthalmologists and their staff in our area give up on costly silicone elastomer, soft and RGP lenses due to lens loss or poor fits, scleral lenses may be the only way to save these patients from vision loss. The obvious need here is for a low-cost, well-fitting, disposable silicone hydrogel lens or even a low-cost hydrogel disposable pediatric aphakic lens. Yes, I'm talking to you big manufacturers. You could even charge more for these lenses than the ones you're selling to low myopes and hyperopes. I realize not many babies need these lenses, but they sure need them more than any of your other patients.

In the early to mid-1980s when Dow Corning was planning to get out of the silicone contact lens business, a prominent pediatric ophthalmologist, John W. Simon, threatened Dow Corning with negative media exposure if they exited the pediatric aphakic lens business. A cagey Dow Corning Health Care Business VP offered to sell Dow Corning's unprofitable silicone lens business to Dr. Simon so he could make the lenses and save the babies' vision. Fortunately, Bausch & Lomb bought the silicone elastomer lens from Dow Corning, so these lenses are still available, and Dr. Simon didn't have to invest his life savings in making contact lenses for babies.

But these lenses are expensive and sometimes just don't work. I have discussed this need for pediatric aphakic lenses with the current silicone hydrogel lens manufacturers, and they are responding with some efforts to develop these designs. Let's hope their regulatory, legal and marketing priority challenges don't get in the way of helping the babies. You disposable hydrogel lens manufacturers may want to think about the babies, too. Not only would it be a good PR move, but you might actually save some sight.