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What I have learned

Age is no barrier

Behavioural optometrist, Bhavin Shah, tells OT  about managing eight-year-old Rian’s myopia with contact lenses, and how he helped dad, Hiten Shah, overcome his concerns

31 Jan 2018 by Andrew McClean

What happened when Rian went for a sight test?

Hiten Shah (HS): Rian told us that he had trouble reading the board during class. My wife and I are both short-sighted, so we were concerned he would be too. After the test, Bhavin suggested that we monitor Rian for six months to see how his eyes progress, and then look at various myopia control methods.

Bhavin Shah (BS): I had seen Rian a year before and he was slightly long-sighted. I was alarmed to see that his vision had changed so much. It was no surprise that he was struggling to see in class. I advised them about current myopia research and the importance of outdoor time as a protective measure.

What were the next steps?

HS: Bhavin explained various myopia control methods, but suggested we start with MiSight contact lenses. As they were not currently available, we started with Dual Focus daily lenses. Bhavin practised with Rian until he got the hang of it. Although Rian struggled for the first two to three weeks, he can now can put them in within seconds.

BS: I told Rian about wearing contact lenses, and ensured that we had his consent and understanding about why we were fitting him with them. He understood that as well as giving him clear vision, they may help in slowing the change in his eyes. I applied a pair of contact lenses on his eyes so he could feel the process and see the improvement in his vision. At this point, he was happy to continue and learn how to insert and remove the lenses himself.

"Although we were a little apprehensive at the beginning, we found that young children are very good at handling lenses and age should not be a barrier "

Did you have concerns about Rian wearing contact lenses?

HS: We were a little bit concerned about Rian wearing lenses at eight years old, but because my wife and I have worn lenses and Rian is quite sensible, we were eager to give it a try. Although we were a little apprehensive at the beginning, we found that young children are very good at handling lenses and age should not be a barrier.

How did you help alleviate Hiten’s worries? 

BS: I explained that children are often more compliant wearers because they are used to being told what to do. I find that children gain more confidence when wearing contact lenses as opposed to glasses as well – especially in sports. I reassured Hiten that daily disposable lenses have a very low risk of infection as well. Hiten was also very concerned about the consequences and risks of myopia, so not doing anything to reduce the change is a bigger risk.

What have been the results since Rian has started wearing contact lenses?

HS: Rian now loves wearing the lenses and feels very comfortable with them in. He likes not having to wear glasses during sports and other playtime activities. We have been really surprised and pleased with the results.

BS: The results have been excellent. After a year, one eye hasn’t changed at all, while the other has only changed by -0.25DS. He started contact lens wear with a prescription of R-2.25DS, L-2.50DS.

"It really helps to hear the child's concerns in their own words so you can re-assure them in a way they understand"

Have you changed your opinion on children wearing contact lenses? 

HS: We would highly recommend the lenses to other parents with children in the same situation. Although it does depend on the child, and Rian is quite careful in his routine. Bhavin has been amazing and really explained the pros and cons of wearing the lenses. He has also been very patient with Rian.

Have you changed your approach in practice based on this experience?

BS: I have changed the way we approach myopia and myopia control in practice from a passive correction to an active process. We have to take a different approach to introducing contact lenses to children because they may have their own fears and reservations. Being calm and engaging with the children helps the entire process of fitting the contact lenses. It really helps to hear the child’s concerns in their own words so you can re-assure them in a way they understand.

It has given me more confidence in fitting children and managing myopia in practice. Also, it has shown me that a young age is not a barrier.

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