G Kids and contact lenses: What is the right Age?

Pediatrics Caring For the Developing Eye
Kids and Contact
Lenses: What is the
Right Age?
Leading voices rate the child’s maturity and interest level ahead of any particular age.
By W. Lee Ball J r ., OD
G
etting contact lenses used to be a teenage
rite of passage, like braces and driving lessons.
But the availability of multipurpose solutions
and frequent-replacement soft contact lenses
made from highly oxygenated materials has made contact lens wear easier and more comfortable than ever
before. In recognition of this, many practitioners are
lowering the age at which they typically initiate lens
wear.
“I am very comfortable fitting kids who are 8 or
9 years old,” says Mary Lou French, OD, MEd. “For me,
the child’s maturity level and interest in contact lens
wear are far more important factors than age.”
In a 2010 survey conducted by the American
Optometric Association Research and Information
Center in conjunction with the association’s Sports
Vision Section and Contact Lens and Cornea Sections
(with support from Vistakon Division of Johnson &
Johnson Vision Care, Inc.), optometrists said they were
more likely than they had been the previous year to fit
children in every age group, beginning with children as
young as 8 years of age.1
More than half (51%) felt it was appropriate to
introduce children to soft contact lenses between the
ages of 10 and 12 years. One-quarter (24.3%) were
comfortable fitting kids at age 8, and nearly another
quarter (22.6%) said that 13 to 14 years old was a more
suitable age. Nearly all respondents (96%) say that a
child’s interest and motivation to wear contact lenses is
the most important factor to consider in fitting a child
with contacts. Also very important to doctors are a
child’s maturity level (93%), ability to take care of contact lenses by themselves (89%), and personal hygiene
habits (89%).
“There is a spectrum of readiness
for contact lens wear that has very
little to do with age. Some
8-year-olds have the maturity to
handle contact lenses, while some
13-year-olds do not.”
There is a spectrum of readiness for contact lens wear
that has very little to do with age. Some 8-year-olds
have the maturity to handle contact lenses, while some
13-year-olds do not. Taking into account the readiness
of the child—and his or her parents—is part of providing individualized, patient-centered health care.
BENEFITS OF CONTACT LENS WEAR
“Research shows that both children and teens can
benefit from wearing contact lenses and that there are
minimal age-based differences in safety or ease of fit,”
says Jeffrey J. Walline, OD, PhD. “The doctor’s chair time
in fitting and following 8- to 12-year-olds is about the
same as the chair time to fit teens, and concerns about
contact lens problems in these younger age groups are
largely unfounded,” he says.2,3
As co-investigator of the Adolescent and Child
Health Initiative to Encourage Vision Empowerment
(ACHIEVE) Study, Dr. Walline found that the benefits
of contact lens wear extend well beyond vision. In the
3-year, multisite ACHIEVE Study, the largest randomized trial of its kind, nearsighted children ages 8 to
11 years old felt better about their physical appearance,
April 2013 Advanced ocular care 17
Pediatrics Caring For the Developing Eye
acceptance among friends, and athletic competence
when they wore contact lenses.4
I know from personal experience that contact lenses
can make a huge difference in self-esteem and performance. As a child, I liked to exercise but rarely did
because my glasses slipped around on my face. Being
moderately myopic, I could not see without them, but
the smaller image size and impaired hand-eye coordination while wearing glasses made sports challenging.
Contact lenses empowered me to become much more
active and successful in team sports. As a practitioner,
I have often seen contact lenses boost a child’s confidence—or give him or her back that crisp vision that
he or she lacked when trying to play sports without
glasses.
Dr. French also likes to fit active kids, because they
are highly motivated to succeed in contact lenses.
“These patients are used to rules and schedules and
accustomed to taking care of their sports gear, so they
tend to be compliant contact lens wearers, too,” she
says.
Even when young patients do not ask her directly,
Dr. French plants the seed by talking about contact
lenses as soon as there is a need for vision correction.
Many parents do not realize that contact lenses are an
option for kids, so it is a good idea to start that education process from the beginning.
To assist practitioners in helping new and current
contact lens wearers better understand how to safely
wear and care for their contacts, Johnson & Johnson
Vision Care, Inc., developed “Healthy Vision & Contact
Lenses,” an educational resource for in-office, website,
and social media use. In a patient-friendly way, it offers
tips for caring for contact lenses and lens cases, and has
space for writing in the lens brand and replacement
schedule.
It is important to share with parents all the technological advancements in today’s contact lenses, such as
breathable materials, ultraviolet light protection, and
shorter wearing schedules. Daily disposable contact
lenses have become the most frequently prescribed
lenses for children 12 years old and younger,1 in part
because they alleviate parental concerns about whether
children can clean and maintain the lenses properly.
W. Lee Ball Jr., OD, is the associate director
of professional affairs for Vistakon Division of
Johnson & Johnson Vision Care, Inc. Dr. Ball
may be reached at (904) 443-1383;
wball@its.jnj.com.
Mary Lou French, OD, MEd, is in practice
at Children’s Eyecare located in Orland Park,
Illinois. She has no financial interests or consulting relationships related to this article, but has
served as a consultant to Vistakon. Dr. French
may be reached at 708-403-0123;
mlfrenchod@comcast.net.
Jeffrey J. Walline, OD, PhD, is an associate
professor at The Ohio State University College of
Optometry and served as principal investigator
on both the CLIP and ACHIEVE studies. He has
received honoraria from Johnson & Johnson
Vision Care Inc., and the ACHIEVE study was supported by
funding from Johnson & Johnson Vision Care, Inc. and The
Vision Care Institute, LLC. Dr. Walline may be reached at
(614) 247-6840; walline.1@osu.edu
AN IMPORTANT DEMOGRAPHIC
Dr. French’s practice is made up almost entirely of
pediatric patients, but even in a general practice setting, children make up a substantial part of the practice, with children up to 17 years of age accounting for
about 41% of contact lens patients.1 As that number
grows, practitioners who set an arbitrary age limit of 13
1. Children & Contact Lenses: Doctors’ Attitudes and Practices in Fitting Children in Contacts. The American
Optometric Association (AOA) Research and Information Center in conjunction with the Sports Vision Section and
Contact Lens and Cornea Sections of AOA, with support from Vistakon, Division of Johnson & Johnson Vision Care,
Inc. 2010. http://www.aoa.org/documents/npr10520_Executivesummarychildrenandcontactlensesstudy_final.
pdf. Accessed March 20, 2013.
2. Walline JJ, Gaume A, Jones LA, et al. Benefits of contact lens wear for children and teens. Eye Contact Lens.
2007;33(6 Pt 1):317-321.
3. Walline JJ, Jones LA, Rah MJ, et al; CLIP Study Group. Contact Lenses In Pediatrics (CLIP) Study: chair time and
ocular health. Optom Vis Sci. 2007;84(9):896-902.
4. Walline JJ, Jones LA, Sinnott L, et al. Randomized trial of the effect of contact lens wear on self-perception in
children. Optom Vis Sci. 2009;86:222-232.
18 Advanced ocular care April 2013
“I know from
personal experience
that contact lenses
can make a huge difference
in self-esteem
and performance.”
or 14 may be missing some important opportunities for
practice growth.
According to Dr. French, “If you don’t fit kids, you are
missing out not only on potential revenues and opportunities for referrals to friends and family members, but
you are also missing the joy of changing a child’s life for
the better.”
“Healthy Vision & Contact Lenses” is available in a
customizable PDF at www.acuvueprofessional.com/
hvcl or as a printed pad of tear sheets, which can be
obtained by emailing healthyvision@its.jnj.com. n