Contact Lens Practice Pearls

Focus on the Kids

By Jason R. Miller, OD, MBA, FAAO

With kids returning to school, anticipating their next grade, the excitement is in the air. Many of them are looking to enhance their image, improve their athletic abilities, and are consequently turning to contact lens wear.

Don’t miss this opportunity!

When fitting children with contact lenses, consider the selfesteem benefits that may result. There is a statistically significant improvement in self-perception regarding physical appearance, athletic competence, and social acceptance in children wearing contact lenses versus those wearing spectacles (Walline et al, 2009). With contact lenses, wearers do not have to think twice about getting involved in physical activity; there’s no fear of damaging their glasses.

Focus on Providing a Strong Foundation

Teaching children proper application and removal techniques can be particularly challenging. Patient responsibility is very important at any age, but it is a critical factor in the pediatric population.

Practitioners may try to judge the level of a child’s responsibility during the exam, but it is also critical to discuss the child’s habits with the parent to determine whether the child is responsible enough to care for contact lenses.

Be sensitive to the fact that some parents may not think that their child is responsible enough for contact lenses due to preconceived notions about their child simply being too young for contact lenses. In these instances, you must reassure parents that contact lenses are safe for children. Understand that while age is significant, it should be only one factor in our final decision. Research has shown that both children (ages 8 to 12) and teenagers (ages 13 to 17) can safely wear contact lenses (Walline et al, 2007). Information based on your previous fitting experiences, coupled with current research on contact lens safety in pediatric patients, will increase parents’ comfort level.

Many Options to Consider

Current eyecare practitioners have many material and design options to consider in soft, hybrid, and GP modalities that are well suited for most patients.

Contact lenses provide the optics directly on the eye and minimize much of the magnification and minimization that spectacle lenses and high myopic and hyperopic correction may induce. Contact lenses also minimize the effects of aniseikonia secondary to significant anisometropia.

A Personal Case This was exactly what happened with my son. His visual system developed with a +4.50DS refractive error in his right eye and a +0.25DS refractive error in his left eye. He was initially managed with spectacles and amblyopia treatment, then transitioned to wearing one contact lens in his hyperopic eye at a very young age. This proved to be very beneficial in his situation.

Take the Initiative to Recommend Contact Lenses

Most children have a healthy anterior segment and will be ideal for contact lens wear. Try a proactive approach and recommend contact lenses for children. Additionally, take a little extra time to make sure that the patients understand their responsibilities with contact lens wear. Discuss the various options and consider daily disposable contact lenses with this unique population. Fitting younger patients is one of the most rewarding experiences that a practitioner can have. CLS

For references, please visit www.clspectrum.com/references.asp and click on document #214.

Dr. Miller is in a partnership private practice in Powell, Ohio, and is an adjunct faculty member for The Ohio State University College of Optometry. He has received honoraria for writing, speaking, acting in an advisory capacity, or research from Alcon, Allergan, CooperVision, and Visioneering Technologies. You can reach him at drmiller@eyecarepowell.com.