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Sylvia, a 12-year-old girl, presented to my office last fall with complaints of trouble seeing the board in class and some eyestrain while reading. She turned out to have low hyperopic astigmatism, and a pair of glasses was prescribed for classroom use and any near work.
When children need spectacle correction for the first time, contact lenses are not always at the front of the patient’s, parents’, or doctor’s mind. Glasses are certainly a must, but what about offering contact lenses? What is the appropriate age for first-time contact lens wear?
Sylvia returned in the spring with her mom in hopes of getting contact lenses for soccer. Unbeknownst to us (because we didn’t ask), Sylvia was a passionate athlete. She enjoyed her vision with her glasses so much that she wore them all the time. Her mom related that wearing her glasses made her feel more confident on the field, but that they would sometimes fog up or fall off.
We fitted Sylvia with daily disposable toric contact lenses. She picked up lens handling quickly, and her comfort and acuity were excellent. She left with a smile on her face. At her 1-week follow-up visit, she was an enthusiastic contact lens wearer, excited to be able to play sports without glasses. Her coach related to her mother that she seemed to play with more confidence with her new contact lenses.
Age or Personality?
A recent study found that contact lens wearers aged 8 to 12 years had the lowest incidence of bacterial keratitis compared with lens wearers up to age 19.1 I have found that most kids prove adept at lens handling. Rather than setting some arbitrary minimum age, I find that maturity, responsibility, and interest level are important factors when considering offering contact lenses to pediatric patients.
Daily disposable lenses are the clear choice for kids in my practice. This modality is a safer option than reusable silicone hydrogel lenses.2
Several studies have shown that children have higher self-esteem with contact lenses than with spectacles.3-5 One study in children aged 8 to 11 years found that physical appearance, athletic competence, and social acceptance were all greater among contact lens wearers than in children wearing glasses.6
When young patients present with a refractive error, be sure to consider contact lenses as an option. It can make a real difference in their quality of life.
1. Bullimore MA. The safety of soft contact lenses in children. Optom Vis Sci. 2017;94(6):638-646.
2. Chalmers RL, Hickson-Curran SB, Keay L, et al. Rates of adverse events with hydrogel and silicone hydrogel daily disposable lenses in a large postmarket surveillance registry: the TEMPO Registry. Invest Ophthalmol Vis Sci. 2015;56:654-663.
3. Walline JJ, Lorenz KO, Nichols JJ. Long-term contact lens wear of children and teens. Eye Contact Lens. 2013;39(4):283-289.
4. [No authors listed]. Vistakon-sponsored study indicates kids, teens prefer contact lenses over glasses. Vision Monday. www.visionmonday.com/latest-news/article/vistakon-sponsored-study-indicates-kids-teens-prefer-contact-lenses-over-glasses-4702/. Accessed June 8, 2017.
5. Walline JJ, Gaume A, Jones LA, et al. Benefits of contact lens wear for children and teens. Eye Contact Lens. 2007:33(6 Pt 1):317-321.
6. Walline JJ, Jones LA, Sinnott L, et al. Randomized trial of the effect of contact lens wear on self-perception in children. Optom Vis Sci. 2009;86(3):222-232.