Pediatric and Teen CL Care

Younger Patients can Succeed With Contact Lens Wear

By Mary Lou French, OD, MEd, FAAO

My favorite contact lens patients are 8- and 9-year-olds, especially if they began wearing a vision correction in first or second grade. I do not mean that all patients this age are going to be good contact lens patients, but a significant number of them succeed and continue to be successful contact lens wearers.

Why Fit Younger Patients?

Material Advances Back in the day, the difficulty in fitting children with contact lenses was the limited availability of lens options—there were only PMMA lenses. With the advent of GP lens materials, contact lenses became more comfortable with improved oxygen permeability, but they remained rigid with the attendant discomfort potential.

Fast forward to 2011, and what could be easier than single-use daily disposable contact lenses, both in hydrogel and silicone hydrogel material?

Younger Patients are Not Much Different From Teens Data from the Contact Lenses in Pediatrics study, as well as my personal experience fitting young children with contact lenses, provide significant reasons to offer contact lenses as a viable vision correction to your young patients and not exclusively to your teen patients. In this study, chair time, adverse events, and a comparison between young children and teens proved that the young children did as well as the teens. Preconceived notions about the safety and time involved with fitting these young patients with contact lenses have been called into question and proven false.

Newer Technology Requires Newer Thinking Parents, practitioners, and staff all have reservations about young children's behavior, level of maturity, and attitude toward wearing contact lenses. Contact lenses are not for all 8-year-olds any more than they are for all 18-year-olds. The foundation for not recommending lenses for young patients is, in my opinion, based on what we learned—and what may still be taught—in optometry school: that we go by the chronological age of the patient, without consideration for the lens modalities available nor the maturity of the patient. While this made sense with rigid lenses and the diligent requirement of compliance with care and disinfection of frequent replacement lenses, it does not apply to single-use lenses.

A Successful Case Example

Case in point is my patient, an 8-year-old gymnast. She began competing at age 4 and started with a vision correction at age 6. With a strong family history of myopia, this year's refraction yielded an increase in her myopia, the same resultant increase as the previous two years. Both the patient and her mom remembered what I had told them about fitting her with contact lenses at age 8. We discussed the pros and cons for her at the completion of the exam and decided to begin the diagnostic evaluation that day.

I chose a single-use lens for the hygiene and ease of care. Her coach had expressed concerns with lens wear and the resin or chalk used in the course of the various events, particularly uneven parallel bars and vault. With single-use lenses, this is not a concern. Even if the chalk gets on the lens, it can easily and immediately be replaced with a new lens. To see how well this 8-year-old manages her lenses, visit http://abclocal.go.com/wls/story?section=news/health&id=7798000.

Fitting young children with contact lenses is one of the best parts of my job! CLS

For references, please visit www.clspectrum.com/references.asp and click on document #185.

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Dr. French is a graduate of Illinois College of Optometry. After her doctorate, she completed post-doctoral programs in learning disabilities, early childhood development, and business management. She is a lecturer, author, and industry consultant specializing in children's vision. She is also a consultant or advisor to Vistakon. You can reach her at mlfrenchod@childrenseyes.com.