Many pediatric patients participate in competitive sports or other highly competitive extracurricular activities that demand their best possible vision correction. It is commonly known that GP optics have the capability to offer superior optical correction for astigmatic patients in comparison to soft toric contact lenses. Nonetheless, corneal GPs may be challenging to successfully fit on active children because they are susceptible to dislodgment and may cause problems in dusty and windy conditions.

Hybrid lenses provide the exceptional clarity of GP optics, but they also offer qualities similar to soft contact lenses such as increased stability and comfort. Hybrid lenses should be considered a choice for astigmatic correction in active pediatric patients who have astigmatism.

A Hybrid Primer

Hybrid contact lenses are composed of a large-diameter GP center zone fused to a peripheral zone made of soft lens material. Current hybrid lenses available in the United States can provide good contact lens health to pediatric patients.

The latest designs employ highly breathable materials offering a Dk of 130 and 84 for the GP center zone and peripheral skirt, respectively. These new materials minimize or eliminate the hypoxic effects that sometimes occurred in previous hybrid lens designs (Pilskalns et al, 2007; Papas, 2006).

Because the skirt is made of silicone hydrogel material, it is less susceptible to binding (Brennan and Bruce, 1995; Swarbrick and Holden, 1994; Dumbleton and Jones, 2008). Additionally, the new designs available have a widened transition zone, which helps ensure adequate tear exchange.

Furthermore, empirical fitting of hybrid lenses can make it easy and time efficient when fitting pediatric patients. Hybrids for normal corneas are recommended to be fitted empirically.

Solution for an Active Kid

Spherical corneal GP lenses are able to mask about 2.50D of corneal astigmatism. Larger amounts of astigmatism will cause lenses to decenter and/or rock, providing a poor lens-to-cornea fit.

Although current hybrids are only available in spherical base curves, they are approved to correct up to 6.00D of corneal astigmatism, thus making them a great choice for vision correction in highly astigmatic children. Take, for example, a 7-year-old female basketball player who had a manifest spectacle refraction of +1.00 –1.25 x 090 in the right eye and +0.50 –3.25 x 090 in the left eye.

Clear or stable vision with soft toric lenses was not achievable for this young patient. Therefore, she was fitted into a hybrid lens design (Figure 1). The patient corrected to 20/20 in the right eye and to 20/30 in her left eye, which had refractive amblyopia. The patient demonstrated completely independent application and removal of the hybrid lenses and was happy with her vision correction and comfort.

In Conclusion

Hybrid contact lenses are a great vision correction option for children, especially those who have astigmatism. In such patients, the GP optics offer sharper and more stable vision in comparison to soft toric lenses.

Educating patients and their parents about the benefits of GP lenses, as well as setting the right expectations during the fitting process, is key to the success of hybrid lenses in children. CLS

For references, please visit www.clspectrum.com/references and click on document #271.