Article Date: 12/1/2012

Pediatric and Teen CL Care
Pediatric and Teen CL Care

Options for Pediatric Patients

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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.



Contact Lens Spectrum, Volume: 27 , Issue: December 2012, page(s): 50