Pediatric and Teen CL Care

Colored Contact Lenses for Children

BY MELANIE FROGOZO, OD, FAAO

Colored lenses can add an interesting and fun aspect to your contact lens practice. In addition, colored lenses have an important role as prosthetics for diseased and traumatized eyes. Children can benefit from wearing colored contact lenses for a variety of medical and cosmetic reasons. This article will review a few of those reasons.

Amblyopia

Some children develop dermatitis to the stick-on patches used in treating amblyopia. To prevent any such irritation, a colored contact lens with an opaque pupil can be used as a patch over the better-seeing eye.

Achromatopsia and Albinism

Rod monochromacy or achromatopsia is an autosomal recessive congenital color defect. Children who have achromatopsia have abnormal or absent cone function that causes debilitating photophobia. Dark-tinted glasses can help with symptoms; however, spectacles may not always be cosmetically acceptable. A dark-tinted colored contact lens can reduce light exposure in a more cosmetically acceptable way (Sindt, 2006).

Children who have albinism have a lack of ocular pigment and iris transillumination defects. Therefore, these patients are also very light sensitive. These children can benefit from heavily tinted or opaque-iris-ring contact lenses that help block light.

Colobomas

Iris colobomas can be corrected cosmetically using an iris-occluding prosthetic contact lens. Patients who have this condition are often photosensitive and can benefit from a black backing on the posterior surface of the lens to help block light. Children who have iris coloboma may also have lenticular and retinal involvement that will limit vision.

Microcornea

Children who have unilateral microcornea have a pronounced difference in their visible iris diameters. This can be corrected cosmetically with a prosthetic contact lens that has a limbal ring to increase the appearance of the overall size of the cornea. When designing a contact lens for children who have microcornea, take into consideration that these patients typically have high refractive errors and steep corneas.

A Case for Fitting a Tinted Soft Contact Lens

A 12-year-old boy presented with complaints of severe migraines from bright outdoor lighting. Dark sunglasses helped relieve his symptoms; however, he wanted to be able to use his full peripheral vision while participating in sports and other extracurricular activities. A dark brown tinted soft contact lens completely resolved his symptoms (Figure 1).

Figure 1. A 12-year-old boy fitted into a brown tinted lens (right eye) to help with light sensitivity.

Summary

Colored lenses have both therapeutic and cosmetic applications for various eye conditions. Prosthetic contact lenses, in particular, can help with severe light sensitivity and cosmesis. Keep in mind the benefits of colored lenses when working with this special population. CLS

For references, please visit www.clspectrum.com/references and click on document #241.

Dr. Frogozo specializes in adult and pediatric specialty contact lenses. She is the director of the Contact Lens Institute of San Antonio and the owner of Alamo Eye Care in San Antonio, Texas. You can contact her at contactlensinstitutesa@gmail.com.