Children and Contact Lens Wear:
The choice to begin contact lens wear is a decision made best by the child, the parent/guardian, and your pediatric eye doctor as a team. Although there is no set age as to when contact lens wear is appropriate, several factors are taken into consideration before a child is considered a contact lens candidate:
- Glasses prescription requirement. This includes the strength of the glasses prescription, if there is a large difference between the power of each eye, if the child is dependent on the glasses for all visual needs or just some, and physical inability to wear glasses during certain activities.
- Child’s maturity level
- Child’s interest and motivation to wear the contact lenses, and how often and for what purpose
- Child’s ability to maintain and take care of the contact lenses by themselves
- Child’s dexterity and ability to safely insert and remove the contact lenses by themselves
- Child’s personal hygiene
- Child’s participation in specific sports or activities that contact lens wear is desired for
- Parent’s willingness to participate and help the child with any concerns or problems at home with the contact lenses
If your child is a candidate for contact lens wear then a comprehensive contact lens fitting and insertion/removal/maintenance instruction session will be scheduled.
The contact lens fitting process includes:
- Corneal topography, a curvature map of the front surface of the eye (the cornea)
- Eye health assessment
- Glasses prescription evaluation
- Trial contact lens assessment on the eye to ensure a healthy fit and good vision
- A trial contact lens pair that the patient takes home to evaluate comfort and vision over several hours and days of wear time
- Any follow-ups needed to re-evaluate the fit of the contact lens or vision with the contact lens over a one-year period
The type of contact lens prescribed is another personal decision to best be made by the child, parent/guardian, and pediatric eye doctor as a team. The healthiest contact lens modality to be fit, especially in children, is a daily disposable contact lens. This is a contact that is worn during the day and disposed of at the end of the day. Each day a new pair is used. This eliminates possible bacteria and waste build-up on the surface of the contacts over time. Daily disposable contacts are also easier to maintain as there is no solution or storage or cleaning of the lenses needed.
Another excellent contact lens choice is Orthokeratology in which a specialty gas-permeable rigid lens is fit specifically for your child’s eye. The child sleeps in the contact lens overnight and removes each morning and has clear vision throughout the day as the cornea is reshaped by the rigid lens. During the day, the contact lenses are not being exposed to the dirt and debris from daily activities and can be cleaned easily after removal. Orthokeratology is now also being appreciated for its ability to slow the progression of myopia, or nearsightedness, in children. A number of published clinical trials have shown that Orthokeratology lenses inhibits the growth of the eye’s axial length, which determines the severity of myopia. So if your child is becoming increasingly more nearsighted with each visit, this may be the best option.
Other soft contact lens modalities include disposable lenses every 2 weeks or every month, depending on the contact lens brand. These lenses need to be removed nightly and meticulously cleaned and stored in appropriate solution to maintain their integrity to ensure eye health.
There are contact lenses approved for extended wear. These lenses have enough oxygen permeability that the contacts are approved to be slept in for several nights in a row without removal. Often this is not an ideal option in children, but if the patient situation is appropriate this may be an option to consider.
It is important to note that contact lenses are a medical device that sits directly on the front surface of the eye. Even with new technology all contact lenses deprive the eye some degree of oxygen, which is vital for eye health. The deprivation of oxygen as well as the buildup of bacteria and waste products on the contact itself puts the eye at risk for inflammation or infection. Some infections can be severe and sight threatening. If the eye becomes red or irritated, the contact lenses should be removed and you should call your pediatric eye doctor.
With the multitude of contact lens options to correct nearsightedness, farsightedness, astigmatism, and even bifocals, contact lenses are a safe, comfortable, and effective way of having great vision without glasses.