pediatric and teen cl care

Turn Anxiety into Enthusiasm With Young Lens Wearers

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

The initial motivation for wearing contact lenses must come from the wearer. That's what we're all taught to believe and that's what most of us practice on a regular basis.

Patients who don't want to touch their eyes may be unable to remove a lens when difficulties arise. Patients who don't want to take the time to clean their lenses are more likely to suffer ill effects of contact lens wear.

Whatever the reason, patients who have insufficient motivation for contact lens wear may put themselves at higher risk for contact lens-associated complications, and prudent practitioners don't typically wish to fit these patients.

Children, however, represent a different demographic for contact lens wear compared to most adults. They don't necessarily have to show that initial motivation for contact lens wear that we typically require for adults.

Parents often see the benefits of contact lens wear before their children do and may ask to have a child fit before he is completely enthusiastic. Even if a child isn't initially motivated to wear contact lenses, it may be advantageous to apply a pair of lenses to let him experience the benefits. This will help the child decide whether his initial reaction to contact lens wear was appropriate.

Illuminating the Positive

Children are afraid of the unknown — especially in a doctor's office when anything even remotely imitating eye drops may be used. A child often associates anything being placed in the eye with stinging that carries absolutely no related benefit. He may believe that contact lenses are going to burn and will have no positive effect on his vision.

If a child doesn't like something, it's difficult to get him interested in pursuing the endeavor. When was the last time that a child enthusiastically took out the garbage? A child who thinks that contact lenses may burn won't be motivated for contact lens wear, but that doesn't mean he won't change his mind.

Applying a trial lens onto a child's eyes can be beneficial even while the child may be noticeably nervous or upset. Once the lenses are on the eyes, he'll notice that the contact lenses are comfortable and his vision is clear.

Now that you've allayed the child's initial anxiety and the benefits are obvious, he's likely to be motivated to wear contact lenses.

Occasionally, children as well as adults are initially motivated to wear contact lenses, but the novelty wears off and motivation wanes. If this occurs, the child is unlikely to wear the contact lenses and so the risk of ocular complications is not increased. However, practitioners should assess a child's motivation for lens wear at each visit and shape the treatment plan accordingly.

Contact Lens Converts

Teaching children how to apply and remove contact lenses is easier if they are motivated to wear them, but the initial motivation to wear contact lenses is not essential for long-term success in children.

Anxiety at the beginning of the fitting process may make enthusiasm for contact lens wear difficult at first, but experience with contact lenses frequently converts children to devotees.CLS

Dr. Walline is an assistant professor at The Ohio State University College of Optometry, where he conducts studies of pediatric contact lens wear. 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.