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Pediatric Contact Lenses

Contact lenses can greatly benefit a child with special refractive needs.

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Children with contact lenses?

When people think of contact lenses, they don’t normally associate them with children. However, contact lenses can greatly benefit a child with special refractive needs. If your child is in sports and their glasses tend to get in the way or fog up during a game, contact lenses may be beneficial. For children with unequal blurry images between each eye, otherwise known as anisometropia, the use of contact lenses can help their brain see equal images. A child that is bothered by the cosmetic appearance of glasses may benefit from contact lenses by improving their confidence and self-esteem. A child that was born with a congenital cataract and then had it removed, contact lenses can help them see clearly and promote normal vision development. A child with eye diseases that result in extreme light sensitivity can benefit from contact lenses that have a colored tint in them to reduce glare. There are many indications for contact lens use in younger populations. The parents play a large role in the use of contact lenses in children. Schedule an eye exam to see if contact lenses are right for you and your child.


What are some indications for contact lenses in children?

Aphakia

A child born with congenital cataracts must undergo cataract surgery to remove the lenses in the eye. This differs from a cataract removal in an elderly patient because in children nothing replaces the lens once it is removed. This leaves the child with an extremely large refractive error at a young age. They will require high amounts of magnification or plus power in their prescriptions in order to correct for their large refractive error. After the surgery, a child is typically fit with a high-powered contact lens. This is done to ensure that light is properly focused on the back of the eye. This is crucial for normal visual development as they grow.

Children in sports

Children who are active in sports may be limited by the use of glasses due to lens fogging or frame discomfort. Children with high refractive errors cannot see clearly without the use of their prescription. Sharp vision is often needed to participate in their respective sports. Therefore, children with an active lifestyle tend to benefit from contact lenses by ridding them of the bulky lenses on their faces. The use of a daily disposable lens would be the best option for these patients as it decreases the risk of infection and improves comfort.

Amblyopia/ Anisometropia

Anisometropia refers to unequal refractive errors or blurry images between the eyes. This type of vision impairment left untreated can lead to chronic vision loss in one eye that is referred to as amblyopia. This is because one eye is not stimulated equally to the other eye and therefore does not develop completely. It is important to correct these patients as soon as possible in order to ensure proper vision development. However, because the two eyes have different prescriptions, glasses may not be as cosmetically appealing. For example, if one eye has a prescription of +1.00D and the other eye has a prescription of +10.00D, the 10.00 lens will be much thicker than the 1.00. The use of contact lenses eliminates this concern as the lens thickness will no longer be a factor. If a child shows signs of amblyopia early on, the use of an occluding contact lens can be used to patch one eye to promote normal development. This means the contact lens is opaque and prevents the eye its covering from seeing. This is normally done with the use of eye drops. However, in some patients the use of an occluding contact lens may be more effective.

Prevent nearsightedness from progressing

Nearsighted vision is referred to medically as myopia. This is when a patient can see clearly at near but blurry off in the distance. This can progressively worsen as a child ages, requiring higher prescriptions over time. However, studies have shown that the use of special gas permeable contact lenses called orthokeratology may help limit progression if used in childhood. Orthokeratology lenses are specially designed to be worn during sleep and help gently reshape the eye to slow down vision changes. These lenses are removed during day time hours and the child will be glasses free with clear vision.

Eye diseases

Some eye diseases in children can result in cosmetically and functionally debilitating outcomes. Aniridia describes a condition in which parts of the iris (colored part of the eye) is underdeveloped or missing. This can result in extreme glare due to too much light getting to the back of the eye. It can also be cosmetically concerning. Contacts can be specially designed and painted to mimic the appearance of a normal iris. It will also help to minimize the light sensitivity that would limit every day activities. In children with ocular albinism, the lack of pigment will result in extreme light sensitivity. In some cases, the use of tinted lenses or painted lenses can be beneficial in this population to reduce cosmetic and functional concerns.


What lens types are available?

trial frame young boyA variety of lenses are available to the pediatric population. Many of these are no different from those available to adult populations. Some examples of lens types available include:

  • Conventional soft contact lenses
    • Soft contact lenses are available in silicone hydrogel or hydrogel materials. Daily disposable lenses are preferred in children using soft contact lenses due to better lens hygiene and comfort.
  • Gas permeable contact lenses
    • Gas permeable contact lenses may be preferred due to their increased oxygen permeability to the eye. These lenses are also offered in more lens powers and can be customized more easily to give crisper and clearer vision.
  • Orthokeratology contact lenses
    • Orthokeratology lenses are gas permeable lenses that are worn overnight during sleep to help with corneal reshaping. This lens is removed upon wakening to allow the child to go glasses free during daylight. This lens can also be used to slow the increase of nearsightedness in children.
  • Silsoft contact lenses
    • Silsoft lenses is a special soft contact lens that is designed for extended wear. These lenses are used for children post cataract surgery who do not have a lens replacement. It offers increased oxygen permeability and is therefore safer for the eye. It comes in larger power increments that are needed for this patient population.
  • Scleral contact lenses
    • Scleral contact lenses are often used for more complex cases. Scleral lenses are larger and rest lightly on the white part of the eye. This is in contrast to a conventional soft contact lens that rests directly on the front surface of the eye (the cornea). The benefits of this lens is its ability to help children who have more advanced eye conditions or refractive errors.

Contact lens disadvantages

It is normal for a parent to be speculative of contact lens use in their child. They often wonder about the logistics of application and removal, wear time, and overall cost. Risk of infection may be minimal as long as proper lens hygiene is adhered to. Your eye doctor will go over the proper procedure of insertion, removal, and cleaning regime. Your child should never sleep in his contact lenses to avoid edema of the cornea (front surface of the eye) as well as infections. In terms of cost, special contact lenses can come with a higher price tag. This is because special contact lenses require more time to fit, a higher skill set, and more follow ups. Lens loss is common in children and must be replaced more often due to changes in prescription as their eye grows. Parents must be willing to actively participating in their care.

Insertion and removal

The process of insertion and removal in a younger population does come with its challenges. Most often, parents must also learn to properly care for the lenses as well as learn how to insert and removal the lenses in order to help the child. If the child is especially young such as in infants, the parents will be completely in charge of insertion and removal. In children this young, it typically becomes a two-person job in which one person holds the infant while the other inserts or removes the lenses. In an older child, emphasizing the need to clean their hands before touching their eyes is crucial. Guiding the child during their attempts the first few times helps with building their confidence. Your eye doctor will go over the procedure in office with you to ensure you feel comfortable with the process.