Locum digest

How do I… engage and raise contact lenses with younger patients effectively?

Optometrist and Johnson & Johnson Vision professional affairs consultant, Marie-Therese Hall, shares advice for locums on engaging young patients in contact lens wear

Contact lens on a finger

Perhaps being a contact lens wearer myself, I’ve always been keen to ensure all patients, regardless of age, are aware of their contact lens suitability, and the ways in which they may benefit their day-to-day lives.

In recent years, especially with advances in soft contact lens materials and increased myopia management options, it feels like fitting younger patients with contact lenses has become much more topical amongst practitioners. But is there a ‘right’ age to initiate a contact lens conversation with younger patients and their parents?

The ‘right’ age

When it comes to introducing soft contact lens wear as an option to a younger patient, for me, communication between the patient, the parent and the practitioner is key.

The first step is to uncover whether glasses are currently meeting all needs. Something that helps me determine this for younger patients is whether they come into the practice wearing their glasses or not. For example, the uncorrected 6/24 patient with their glasses in their pocket suggests that their current glasses may be a poor or uncomfortable fit, or emotionally that they may not feel confident to wear their glasses all the time.

Throughout the eye examination, I’m keen to ask about any hobbies or activities the patient enjoys, listening for any instances where they remove their glasses or where glasses have previously been broken. This can help identify instances where soft contact lenses may be of functional benefit, helping the patient to enjoy these activities more.

For new glasses wearers, it is worth considering whether glasses may get in the way of any of their current activities. For sports, regardless of the type, or level played, younger patients and parents may be interested to know the visual benefits of contact lenses such as a wider field of view, glasses not fogging up in the rain or dirt, and enhanced depth perception (Efron N. Why Fit Contact Lenses? Optician 2009 24-32).

The patient and parent relationship

Working as a locum, I’m conscious that it may be the first time that I have met both the patient and their parent, so building rapport and trust as quickly as possible is important.

It’s also important to understand the practice’s approach to fitting younger patients, and whether the support staff are confident or may need my support with the application and removal training.

When introducing the concept of soft contact lenses, I’m conscious to ensure both the patient and the parent understand the benefits, and to look for any cues indicating any questions or concerns either may have. It is also important that both the patient and parent understand that contact lenses are not a total replacement for spectacles and the importance of a combination of vision correction options.

Parents may be concerned that the child is too young, or not responsible enough to look after contact lenses, so it can be helpful to share research insight. For instance, I’ll share that studies have shown that 90% of young contact lens wearers were able to successfully wear and care for their lenses (McParland M and Esterow G. Parent and child attitudes to vision correction. Poster presentation at BCLA, 2014), and that young patients aged eight to 11 are just as capable as those aged 12–17 at looking after contact lenses (Cho P.and Cheung SW. Retardation of Myopia in Orthokeratology (ROMIO) study: a 2-year randomised clinical trial. Invest Ophthalmol Vis Sci 2012;53:11 7077-85). Demonstrating the child’s unaided vision to the parent can help them understand the visual benefit of contact lens correction, and that 80% of parents agreed that contact lenses improved their children’s confidence (In a clinical study that evaluated teen contact lens wearers with teens and parents surveyed. Walline JJ, Jones LA, Rah MJ, et al; CLIP Study Group. Contact Lenses in Pediatric (CLIP) Study: Benefits of Contact Lens Wear for Children and Teens. Eye & Contact Lens 33(6): 317-321, 2007).

For the younger patient worried about ‘touching’ their eyes, language and technique is important. I find it helpful to give them a soft contact lens to ‘play’ with, feeling how soft and flexible it is, or to explain that the contact lens ‘hugs’ the eye.

During the discussion, I aim to allow sufficient time to put everyone at ease and encourage questions from both the patient and the parent. In some instances, it can be helpful to offer reassurance that a decision does not have to be made there and then. If so, sharing written information leaflets, or links to patient information on contact lens manufacturers’ websites can be useful to allow further discussion at home.

In terms of the ‘right’ age to raise the topic of soft contact lenses, I feel that it is more dependent on the ‘right’ time for the patient. Lifestyle information, alongside clinical findings, helps to decide whether current glasses are meeting functional, emotional, or refractive management needs. Instinct will tell you whether the young patient is mature and motivated enough to wear and care for contact lenses properly. For the patient and their parent, it is awareness that contact lenses are an option, and understanding their safety, and the benefits that they may bring.