pediatric and teen cl care

Relating Patient Lifestyle to Contact Lens Needs

BY MARJORIE J. RAH, OD, PHD, & JEFFREY J. WALLINE, OD, PHD

When fitting patients of any age with contact lenses, it's important to take their lifestyle into consideration. Knowing their lifestyle will help in determining what type of lens and what wearing schedule would best fit each patient's needs.

When fitting children and teens with contact lenses, it's important to know, for example, whether they will wear the lenses full-time or part-time. Do they swim regularly? In what other extracurricular activities are they involved?

Consider Their Wear Schedule

If a child wishes to wear contact lenses only while participating in extracurricular activities or will wear them only two or three days per week, a soft lens may be a better choice compared to a GP lens. Adaptation will likely be more difficult for a part-time GP contact lens wearer. Daily disposable soft lenses may actually be a cost effective option for such a patient, assuming a low amount of astigmatism is present.

Consider Their Environment

Just last week, a 12-year-old girl presented for a contact lens consultation. She wore soft contact lenses, but she couldn't wear her contact lenses while participating in her sport — diving. She couldn't participate without vision correction because she was a –3.00D myope. There are also similar patients who are involved with synchronized swimming. All of these children may especially benefit from corneal reshaping contact lenses if they have low to moderate amounts of myopia and astigmatism. This modality provides clear vision without the need to wear glasses or contact lenses during the day, and it greatly reduces the risk of contact lens contamination after swimming in the pool.

Many children go away to summer camps. They often ask whether they should take their contact lenses to camp or whether they should wear glasses while away. Proper hygiene may not be possible in these instances, so you may temporarily prescribe 30-day continuous wear contact lenses. However, you should determine whether the child will be swimming and adjust your prescription accordingly.

Many children play baseball or softball, ride horses or participate in gymnastics. GP contact lenses may not be the best option for children in these settings because dust or chalk often permeates the air and could cause severe irritation if it gets under the lenses.

Consider Lens Handling

Some young children lack fine motor skills necessary to apply and remove soft contact lenses, but these children may benefit greatly from GP lenses because they're smaller, easier to handle and easier to apply to the eyes.

If several options are available for a particular child, you may ask the parents what they wear. Many times a child will benefit from a parent's experience. In addition, if the child is wearing something new to the parents, then the parents are less likely to meet emergencies with a calm demeanor that results from experience.

In a Nutshell

Similar to fitting adult patients with contact lenses, it's very important to take lifestyle into consideration when selecting lenses for your pediatric patients. CLS

Dr. Rah is an assistant professor at the New England College of Optometry where she works primarily in the Cornea and Contact Lens Service in patient care, teaching and research. Dr. Walline is an assistant professor at The Ohio State University College of Optometry, where he conducts studies of pediatric lens wear.