Article Date: 12/1/2012

Pediatric and Teen CL Care

Options for Pediatric Patients

BY CHRISTINE W. SINDT, OD, FAAO

Selecting a contact lens for a child should be done with complete understanding of the advantages and disadvantages of each design. The lens type should be chosen for the ultimate vision and safely profile. Following are different types of lenses available for pediatric patients and the advantages and disadvantages of each.

Soft/Hydrogel Lenses

ADVANTAGES:

• Good initial comfort

• Not easily dislodged

• Rarely get dirt/debris under lens

• Custom designs available; can correct sphere powers from +50.00D to –75.00D in diameters from 6.00mm to 24.00mm, base curves of 5.0mm to 22.0mm, and cylinders up to 15.00D in axes of 1-degree steps

• Tints/painting available

DISADVANTAGES:

• High cost (if custom)

• Slow lab turnaround time

• Difficult to verify

• Low oxygen permeability

• More difficult to handle

• Spoilage/ripping

• Risk of infection/increased risk with extended wear

• Ultraviolet protection not available in all parameters

• Cannot mask large amounts of astigmatism

Silicone Hydrogel Lenses

ADVANTAGES:

• High oxygen permeability

• Good initial comfort

• Not easily dislodged

• Do not easily rip

• Rarely get dirt/debris under lens

• Overnight wear available

• Custom designs available

DISADVANTAGES:

• No tints/painting available

• Ultraviolet protection not available in all parameters

• Possible lipid deposition

Silsoft (Bausch + Lomb) Lenses

ADVANTAGES:

• Good initial comfort

• Hyper-oxygen transmissibility (Dk 340)

• Extended wear option

• Rarely get dirt/debris under lens

• Not easily dislodged

• Do not easily rip

• Easily verifiable (parameters marked on lens)

DISADVANTAGES:

• Surface coat breaks down/milky appearance/nonwetting surface

• High replacement rate

• Expensive

• Ultraviolet protection not available

• Limited parameters; Silsoft Aphakic Adult contact lenses available in base curves of 7.5mm, 7.7mm, 7.9mm, 8.1mm, and 8.3mm, diameters of 11.30mm and 12.5mm, and powers from +11.50D to +20.00D (0.50D steps); Silsoft Super Plus Pediatric contact lenses available in base curves of 7.5mm, 7.7mm, 7.9mm, diameter of 11.30mm, and powers of +23.00D to +32.00D (3.00D steps)

• Gapping at edge of lens can induce astigmatism if lens does not fit properly

GP Lenses

ADVANTAGES:

• Low cost

• Quick lab turnaround

• Good reproducibility

• Easily verified

• Easily cleaned

• Easy to handle

• Wide parameters/custom designs available in any base curve, diameter, or power

• Ultraviolet protection available

• High oxygen permeability

• Excellent optics/mask astigmatism

DISADVANTAGES:

• Prolonged adaptation period/initial comfort

• Greater skill/knowledge needed to fit CLS

Dr. Sindt is a clinical associate professor of ophthalmology and director of the contact lens service at the University of Iowa Department of Ophthalmology and Visual Sciences. She is the past chair of the AOA Cornea and Contact Lens Council. She is a consultant or advisor to Alcon Vision Care and Vistakon and has received research funds from Alcon. You can reach her at christine-sindt@uiowa.edu.

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