Pediatric and Teen CL Care
Younger Children Feel Positive Effects of Lens Wear
By Mary Lou French, OD, MEd, FAAO
Since graduating from optometry school, I have been fitting young children with contact lenses, in spite of common wisdom and the perceived difficulties of the maturity level and the challenges of working with younger patients. Through bitter experience I learned that 10-year-olds were better than younger patients to fit with hard lenses—all that was available at that time. This held true even when GP lenses became available; although improved in oxygen permeability, they were still a rigid material with all of the attendant discomfort and irritation, in addition to the issues inherent with learning lens removal techniques as a young child.
With the advent of soft contact lenses, the ease of fitting young children improved immensely. No longer were there the problems of discomfort and irritation nor the process of building up wearing time by adding hours per day to the wearing schedule to avoid contact lens overwear.
A Life-Changing Event
Imagine that you are 10 again and wearing your first pair of glasses. The world looks differently at kids who wear glasses, and the kids themselves look differently at the world. We as practitioners look at children who wear glasses differently, and they look at us differently. Based on the tears shed in my exam room, they look none too kindly at us, either, for rocking their world.
Imagine that you are a 10-year-old young man, a great baseball player—at least last year, this year not so much. You had a healthy self image, at least until this visit to the eye doctor when you were told that you need to wear glasses, all the time. Your life, as you know it, has ended. You fight back tears because you are a tough kid and only sissies cry, especially in public.
This was my young patient. I could see him shrivel in my chair, self esteem leaking out in puddles. How many patients have you had like this? Completely devastated that they need glasses, although knowing full well that they can't hit the ball so well this year. “Oh, but I hit it out of the park when I connect,” he says. I reply, “Sure you do, but how often has that been this year?”
We are obligated to care for the complete patient in fitting young children with contact lenses just as we do in our care of our diabetic and hypertensive patients. I realize that the last two diagnoses are potentially life and sight threatening, but fitting a young child with contact lenses may have a positive long-term impact, which I view as just as important.
The Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) study, published in 2006, validated all of my clinical impressions since graduation. Interesting to me was that the young children's perception of their improvements in peer perception was slightly higher compared to the teens'. Young children do care about and are as aware of how they look to others long before we thought. Perhaps fitting young children with contact lenses will have a larger impact on their lives than we might suppose.
Let's get back to my baseball-playing patient. He was so convinced that he didn't need either glasses or contact lenses that I bet him $1 that if he wore his contact lenses, his batting average would improve. So, a month later he walks in with his mom, dollar bill in hand! I graciously accepted it—a bet is a bet! CLS
For references, please visit www.clspectrum.com/references.asp and click on document #189.
Dr. French is a graduate of Illinois College of Optometry. After her doctorate, she completed post-doctoral programs in learning disabilities, early childhood development, and business management. She is a lecturer, author, and industry consultant specializing in children's vision. She is also a consultant or advisor to Vistakon. You can reach her at email@example.com.