I recently supervised a pair of third year undergraduate optometry students fitting a young teenager with contact lenses. As a moderate hyperope, she was becoming increasingly self-conscious in her glasses, often “forgetting” to take them to school and forever “losing” them.
Despite her parents’ initial reservations, she was extremely motivated to try contact lenses. The look on her face once she had her lenses in for the first time was priceless and both the students and her mum were amazed by how confidently she handled them.
Giving children the freedom from glasses, whether it’s for full time, occasional wear, special occasions, socialising or sporting activities can be incredibly empowering. Her mum later reported that her daughter had been less withdrawn and appeared more confident. She was also more accepting of her glasses on non-lens wearing days and the issue was becoming less of a battleground. Mum certainly felt that the cost of the lenses was justified by the improvement in her daughter’s wellbeing and appeared to be making a sensitive time in her teenager’s life a little easier.
It’s important to dispel the myths about contact lenses for children; they’re not just for sporty kids or a luxury item, they can be beneficial in a whole range of scenarios. Parents are often surprised how quickly their children get the knack of application and removal. Also, at how responsible they are for their own lens care, especially when they are well motivated to wear lenses. The thought of being able to enjoy their chosen sport, for example, without worrying about breaking their glasses.
Being proactive is key. Often, parents are not aware their children might be suitable for contact lens wear and don’t understand the range of materials and modalities available that can make wearing lenses both convenient and affordable.
It’s therefore all too easy to allow parents to be the initiators but, in fact, simply introducing the idea of contact lenses during a routine eye examination can help inspire them to consider lenses as a viable option for their child. Keeping explanations simple, getting the parent and child to actually touch and feel a lens, and offering them written information specific to children wearing contact lenses can be beneficial.
"Giving children the freedom from glasses, whether it’s for full time, occasional wear, special occasions, socialising or sporting activities can be incredibly empowering"
Keeping an open mind
It’s important to consider each situation individually, being careful not to make assumptions about a child’s dexterity, maturity or risk of complications. Understandably, some practitioners may have a cut-off limit for contact lens fitting below which they may be unwilling to consider them. Indeed, only around 8% of contact lens fits in the UK are to teenagers and 2% to children, according to General Ophthalmic Services statistics – lower than in most other countries.
This may be borne from a perception that children are at a greater risk of complications. However, a recent review article summarising the safety of children wearing contact lenses reported that a number of studies, many of them large-scale, indicated that the incidence of corneal infiltrative events is no higher for children than in adults (Bullimore, 2017) and that patients aged eight to 15 years old were actually at a lower risk than young adults (Chalmers et al, 2011).
Children are quite familiar with rote learning and often follow instructions about lens wear and care to the letter, so their compliance is typically much better than adolescents and young adults.
Dr Evans’ tips for fitting children and teenagers with contact lenses
- Keep a few daily disposable contact lenses to hand for if you bring up the subject of contact lenses during an eye examination. Get parents and children to feel the lenses – this will reassure them and encourage them to take the next step and book a fitting appointment
- Finding the right environment for teaching about lens handling and care can mean the difference between success and failure. A quiet area with a parent, free from the distractions of siblings, is ideal
- Even if the child intends to wear their lenses relatively infrequently in the long term, try to encourage them to wear them every day during the trial period, even if it is only for short periods. This boosts their lens handling skills, cements their lens care regime and encourages them to stick to it
- Following up with a phone call after a few days and keeping the initial trial period short will allow for any potential problems to be addressed swiftly.
Dr Katharine Evans is an optometrist and senior lecturer at the School of Optometry & Vision Sciences, Cardiff University. She is director of clinics and teaches on the second and third year contact lens modules. Dr Evans gained a fellowship of the British Contact Lens Association in 2012 and was awarded Lecturer of the Year at the 2015 AOP Awards. Dr Evans also continues to work regularly at a practice in Hereford.