On Saturday, Jan. 18, during the Global Specialty Lens Symposium (GSLS) in Las Vegas, Daniel Diamond, OD, assistant professor at Columbia University College of Physicians and Surgeons Department of Ophthalmology, and Sharon Keh, OD, assistant professor at Columbia University, presented a course on “Therapeutic Contact Lenses in Pediatric Ophthalmology,” including three specific case reports on the topic.
Course objectives included identifying appropriate pediatric patients for contact lens fitting, developing a tailored treatment plan for pediatric lens wear, demonstrating safe and effective contact lens fitting techniques for children, and emphasizing the importance of collaborative care in pediatric population.
Here, CLS caught up with the speakers to get further intel on these objectives.
CLS: What criteria should eyecare professionals pinpoint to establish whether a pediatric patient is a suitable candidate for contact lens fitting?
Dr. Diamond: There are a few criteria to establish when considering whether a pediatric patient is a good candidate for contact lenses.
First, you need to establish if their condition would benefit from lenses, and if so, which kind? Soft lens technology has progressed a long way, and jumping to GP lenses is not always necessary.
Next, does the patient’s guardian understand the importance of contacts and are they on board with supporting the patient through the fitting process? Education of caretakers is just as important as education of patients for pediatric lens fitting.
Finally, does the patient seem like they are going to be able to physically and mentally tolerate the process? Younger kids are often more tolerant of lenses, but small eyes and apertures can make any fitting more challenging. Additionally, if a physical confrontation or emotional breakdown is initiated every time we approach the patient with a lens, we may be better off seeking other options.
CLS: When establishing a tailored contact lens wear plan, how is a child’s lifestyle factored in?
Dr. Diamond: A child’s lifestyle can play a large role in their success with lenses. Highly active kids might benefit more from being unrestricted by glasses; however, proper lens hygiene needs to be emphasized when there is an increased risk of dirty fingers touching eyes.
Additionally, a large portion of pediatric lenses are medically necessary and might require additional safety precautions. Making sure the patient and their guardians understand protective eyewear is still required even with the lenses is essential.
CLS: How do you address concerns from parents regarding the safety of contact lens wear for children?
Dr. Keh: Open and honest communication is paramount when addressing parental concerns regarding children’s contact lens wear. I understand they might be apprehensive, and I always reassure them that I understand their worries and that their child’s eye health is our shared top priority. We talk openly about the potential risks and benefits, actively involving the child in the decision-making process whenever possible. I also offer to be the go-between for parents and other people involved in their child’s life, like school nurses or camp counselors, if they have any questions about how to take care of their lenses. For kids in school, we use the simple rule: “look well, see well, feel well.” This means we keep a close eye on them for any symptoms that would warrant sooner follow up, like pain, redness, blurry vision, or sensitivity to light.
CLS: In terms of collaborative care, what is the key takeaway for eyecare professionals when they are coordinating with other health care providers to ensure comprehensive care for the child?
Dr. Keh: Successful collaborative care between a specialty contact lens fitter and other health care providers hinges on mutual trust, shared decision-making, and open, timely communication. Clearly communicate your professional recommendations. The patient is being referred to you for your expertise. Collaboratively discuss the best course of action with the referring provider, while ensuring the patient’s best interests are upheld. Finally, given the demanding schedules of health care providers, it is easy to inadvertently assume that all correspondence is promptly reviewed. However, I have found that brief notes or text messages can significantly enhance inter-provider communication and ensure timely awareness of any pertinent changes.