CONTACT LENSES

Eye Contact

How two O.D.s fit young wearers with their first contact lenses

today, more children are being fit with contact lenses at young ages than ever before. But how are O.D.s making that call?

In an American Optometric Association (AOA) survey, supported by Johnson & Johnson’s Vistakon, optometrists were asked what influences their decision to fit younger kids. Nine in 10 said a child’s maturity tops the list, followed by ability to care for the lenses, hygiene habits, sports participation, the Rx, and the impact of contacts on self-esteem. The least important considerations? Cost and gender.

To bring the story of fitting kids to life, we invited two O.D.s to each share a recent fitting experience. Both wearers—a nine-year-old ice skater and an eight-year-old baseball player—were fit by their doctors with Biotrue ONEday lenses by Bausch + Lomb.

Jennifer Fogt, O.D., FAAO
Chief, Pediatric Contact Lens Clinic, and associate professor, The Ohio State University College of Optometry

A nine-year-old myopic competitive figure skater came in who couldn’t wear her glasses because she was spinning and jumping on the ice. She had recently decided, however, that it was scary to skate without clear vision.

While she had a simple spherical prescription, she was challenging because of her fear. She didn’t like eye drops and wouldn’t let me insert a contact lens on our first visit. As soon as I had a lens on my finger, she would close her eyes and turn away.

When I have a pediatric patient who is terrified but is still motivated and may even need the lenses for safety, I step back and let the child take charge.

I let her play with a lens and explained they are wet and squishy, like an eyeball, which is why they’re comfortable. I also pointed out that eyelids do a good job of keeping things out of her eyes, but that she can relax them enough to help me put in the lens. Then, I gave her a bottle of artificial tears, showed her how to put in a drop, and sent her home with instructions to try to put in drops every day for a week. I told her it’s like a new figure skating move—challenging at first, but easy with practice.

When she returned a week later, she was proud of herself, very motivated, but still a little nervous.

I chose Biotrue ONEday for ease of care and because it’s thick enough that we could handle it easily that first day. I had no problem getting the lenses in. She was amazed to see without glasses and surprised she couldn’t feel the lenses.

She came back for follow-up a week later and was so enthusiastic that her older sibling came in for contacts shortly thereafter.

Melanie J. Denton, O.D., MBA, FAAO
Salisbury Eyecare and Eyewear Salisbury, NC

It was this eight-year-old’s first eye exam. His parents were with him, and upon finding out he was a -1.50 myope and would need vision correction, they were very concerned because he was extremely active in travel baseball.

We initially discussed glasses, but after considering his needs and listening to him and his parents, we agreed on glasses for backup but decided that a daily contact lens would be a better everyday solution.

There was some discussion with his parents regarding modalities since they’d heard of only two-week and monthly replacement lenses. Upon learning of the convenience and benefits to eye health, they were on board with a daily lens.

The fit was a home run (pun intended), and, besides sports, we also discussed screen time and use of SmartBoards at school and devices at home.

He did beautifully in his insertion/removal training and was very motivated to take care of his contacts so he wouldn’t have to wear glasses.

The big win here was spending extra time with the parents to discuss their child’s needs and to identify the best solution for him.

It might be tempting to say, “No, eight is too young. Let’s wait until next year.” In this case—with engaged parents and an active, motivated child—daily contacts were the best choice.

The best part? Hearing from other families that the parents were telling everyone how happy they were with the care…and how well their child was able to see!

No doubt about it. Fitting younger patients can be a win-win…for families and for the practice.