There are various reasons that children may be fit into contact lenses. Common indications for pediatric medically necessary contact lens wear are aphakia and irregular astigmatism caused by corneal trauma. Children who have high refractive error, anisometropia, and the need for myopia management are other indications for children’s contact lenses.

Nevertheless, many practitioners resist offering contact lenses to children for several reasons including concerns about motivation and hygiene. Despite this hesitancy, children as young as 8 years old can wear and care for contact lenses (Paquette et al, 2015). Beyond providing visual relief, children are also motivated to wear contact lenses, especially if they are athletically active. The Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) study concluded that contact lenses improve how children feel about their physical appearance, their ability to play sports, and their acceptance among peers (Walline et al, 2009).

Another reason why providers resist prescribing contact lenses to children is the belief that it will take too much chair time. With respect to chair time, the Contact Lenses in Pediatrics (CLIP) study showed that children from 8 to 12 years old took only 15 minutes more to fit in comparison to teens (13 to 17 years of age) (Walline et al, 2007).

At-Home Tasks

Streamlining the entire in-office contact lens process for children can be accomplished by delegating time-consuming tasks. Giving staff members responsibility of application and removal education is effective, as is assigning at-home tasks to patients and their parents. What follows are a few at-home duties that you can assign to patients and parents to improve the adaptation to contact lens wear and to encourage safe and effective lens care:

1) One of the most challenging responsibilities while learning application and removal of contact lenses is keeping the eyelids wide open. To help with this, give patients an at-home task during which the eyelids are touched.

One idea is to dispense artificial tears to patients and ask them to instill a drop in the morning and at nighttime. Giving patients this responsibility will allow them to get used to touching their eyelids daily. Once back in the office, patients will already have gained confidence manipulating their own eyelids for their formal teaching session.

2) Children learn quickly from observing their parents and other family members. If parents or an older sibling already wear contact lenses, have young patients shadow them during their daily lens care and handling routine.

Allowing children to learn by observation at home with someone whom they already trust will help build confidence that they can also demonstrate care and handling of contact lenses while in your office.

3) If patients cannot fully apply and/or remove their lenses by themselves in office, do not hesitate to educate the parents and to delegate this responsibility to them.

At first, this provides the opportunity for children to become comfortable with wearing contact lenses. Eventually, children will gain the courage and will want to engage in learning how to care for and handle their own lenses.

Summary

Contact lenses offer diverse solutions for the various ocular needs of adults and children alike. Currently, at least, eyecare practitioners are the primary source of contact lenses, yet many resist providing lenses to children. This denies children significant visual relief for no good reason.

The opportunities to reach children are actually greater than in adults, as your staff and the child’s family can act as extensions of you. While this requires some creative thinking and a different process, the benefits far outweigh the costs. Patients naturally benefit, but so will you by being perceived as an expert professional who has broad and deep knowledge and abilities to positively change lives. CLS

For references, please visit www.clspectrum.com/references and click on document #313.