Pediatric and Teen CL Care

Protecting and Correcting the Eyes of a Young Swimmer

BY MARY LOU FRENCH, OD, MED, FAAO

Dry eyes and children are usually mutually exclusive, which makes the July Annual Dry Eye Issue a challenge for me. Children’s dryness complaints are typically environmental in nature, rather than stemming from an underlying physical issue.

My younger contact lens patients rarely complain of dry eyes unless they have severe allergies. Those patients, even when wearing single-use lenses, generally refrain from lens wear during their peak allergy season.

Young Athletes Are an Exception

The most obvious young patients who may be affected by and complain of dry eye are young athletes who play a sport in a dusty environment—baseball players, soccer players, and—a new sport for my area—lacrosse players. The fields on which these athletes practice and compete can become quite dry and dusty during various times of the season. Adding to the environmental issues, the patients’ activity level causes them to sweat, which can run into their eyes. Both of these factors can cause contact lenses to dry out and can become underlying causes of dry eyes.

But, what about patients who swim competitively, or who play water polo? Consider how warm and moist it is in an indoor pool setting. Although the thought of dry eyes in a swimmer is counterintuitive, it does happen because the chemicals used to treat pool water alter the chemical composition of the tear layer, creating an evaporative effect. This change in the tear layer is due to an over-concentration of salt, which can result in physical discomfort and blurred vision.

Managing a Myopic and Astigmatic Swimmer

One of my nephews is a competitive swimmer and is also a myopic astigmat. When he began swimming at a young age, his minimal correction did not impair his swimming; standard goggles were sufficient to protect his eyes. As his myopia progressed, he began wearing goggles with a spherical equivalent to compensate for his astigmatism. This became a less-than-adequate correction as his competitive levels increased.

He also began wearing toric contact lenses at this time. I will admit that he was not my most compliant patient. Plus, with all of the practices and meets that he participated in, he began using his two-week lenses as four- to five-use lenses. A daily disposable lens made more sense considering these factors.

An issue with his prescription was his oblique axis of astigmatism. Unfortunately, at that time there were few single-use toric lenses with oblique axes, so I recommended the best available. The good news is that by the time he reached high school and the competition heated up for college scholarships, a daily disposable lens became available that fully corrected his astigmatism at the exact oblique axis that he needed, so he could see clearly for all of his swim meets and not have to reuse his lenses.

Not to say that his corrected vision was responsible for his eventual success at setting state level records for his specialties— but, as his aunt and eyecare practitioner, I’d like to think so. CLS

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.