From the Lane: Pediatric and contact lens specialists weigh in on contact lenses for children

In the June issue of Optometry and Vision Science, Dr. Mark Bullimore published a review of literature examining contact lens safety in children.  “The Safety of Soft Contact Lenses in Children” reviewed 9 prospective studies representing 1800 years of patient wear and found that the incidence of infiltrative keratitis with contact lens wear is no different in children than adults and is in fact lower in children 8-11 years old.

We spoke with children’s vision specialist Kristi Kading, OD, FCOVD, of Specialty Eyecare Group in Kirkland, Washington and contact lens resident Sarah Henderson, OD about their thoughts on contact lens safety in kids, their preferred modalities, and tips for success in fitting children with contact lenses.  Here’s what they had to say:

Q.  Do you consider contact lenses to be a safe option for children?  Why?

A.  Yes! As long as proper instructions are given to children and parents regarding proper length of wear, cleaning and hygiene, contact lenses can be very safe for children. Those who are very active have had great success with contact lenses over glasses, and even prefer them to glasses as well.

Q.  At what age do you start presenting contact lenses as an option for kids?

A.  For children who wish to be free of glasses during the day, I would start recommending soft lenses starting as early as 7 or 8 years old, sometimes younger. The most important factor in having success with kids and contact lenses is if the child wants to wear them. Sometimes the children who struggle to wear their glasses are the best candidates for contact lenses. We train the child and the parent together as children often need help with lens insertion and removal for a few months.

I always present the option of myopia control (e.g., orthokeratology and other methods) with children who have any hint of nearsightedness, but if that is not an option for the patient, I first fit a child in daily disposable contact lenses. They decrease the risk of infection such as microbial keratitis and start healthy habits early.

Q. What is your preferred contact lens modality for children?  Why?

A.  Daily disposable lenses are great for children because they don’t have to worry about storing their lenses and keeping them clean – they just throw them away at the end of each day and use a fresh pair the next day. Daily lenses are not only convenient, but they minimize the risk of infection, are comfortable and are the healthiest modality for contact lens patients.

Q. Do you feel that silicone hydrogel is an important feature in a daily disposable lens? Why?

A.  Very.  SiHy lenses are not only important for patient comfort, but also for health of the cornea.  SiHy lenses have higher Dk values, meaning they are highly oxygen permeable. Daily lenses are also great because patients get the effects of a fresh lens each day.

Q.  So which CooperVision products help meet those needs in your practice?

A.  A highly oxygen permeable lens is most important to us when fitting patients (especially children) in contact lenses.  MyDay® and clariti® from CooperVision fit this mold and have given us success in fitting first time contact lens wearers in a comfortable, healthy contact lens thanks to the silicone hydrogel material.

Q.  Do you feel that contact lenses improve quality of life for children in your practice overall?  Why or why not?

A.  Absolutely.  Contact lenses eliminate the need for glasses during the day and allow patients to see, often times much better than they do out of their glasses.  For children with higher prescriptions or a difference in prescription between the eyes, contact lenses are the best option for both clarity and promoting binocularity and stereopsis. We fit lenses for these children as early as possible. For children who are active, contact lenses improve peripheral vision and their ability to see clearly when looking side to side

Q.  What advice would you give to practitioners who want to start fitting more children (or younger children) in contact lenses?

Daily disposable lenses are a great option for all patients, especially children!  We have seen far fewer infections in our office with patients who use daily disposable lenses.  Additionally, we see them as the best option for patients in the long term.  It avoids solution complications as well as greatly improves the compliance issues encountered with longer term lens wear. And children and parents are happy about it too which can result in practice growth. Research shows that children particularly choose contact lenses over glasses for appearance and activities.



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