Article

CONTACT LENS PRACTICE PEARLS

HOW TO DECIDE WHEN TO FIT A CHILD WITH CONTACT LENSES

Kids and contact lenses. When should I discuss contact lenses? How should I present them? Am I going to make the child’s parents upset by talking about this? I’m a big fan of presenting contact lenses as an excellent option early and often. However, I also think that it is important to have a good peripheral awareness.

Succeeding when presenting contact lenses to children can often be about timing. A child, teen, or parent may not have really thought about contact lenses, or they may have had a negative experience with them in the past; regardless of the situation, practitioners should know which direction to go. Tread lightly because they may have heard about others who have had challenges with contact lenses.

1) The Hard Push

This tactic is for patients who can truly gain a huge potential benefit from wearing contact lenses. Examples of people who would benefit from this tactic include younger patients who have higher prescriptions as well as patients who have a significant amount of aniseikonia, who are in need of myopia control, and who have other medical situations in which contact lenses can have a big impact on their quality of vision.

Start this conversation earlier than when they will actually use contact lenses. Take, for example, a 6-year-old boy who has a +4.00DS prescription in one eye and is plano in the other eye. He has been wearing glasses and has been compliant with his amblyopia treatment. Practitioners should discuss contact lenses as a perfect option in the near future.

Set the stage: “Mrs. Smith, Johnny has been doing great with this treatment, but I want you consider contact lenses soon. They are going to be a great option for him in the next year or two. They will provide more freedom for an active boy and will potentially improve his depth perception and vision in that amblyopic eye. I know that this is early and that it’s is a new idea for you, but let’s discuss contact lenses at our next visit in about six months.”

2. The Soft Recommendation

This tactic may be good for patients who have had glasses since a young age but do not need to wear them all the time and may not have considered contact lenses as an option. These patients may be worried about contact lenses and how to apply and remove them. Consider a 7-year-old myopic female who is in your office for help with blurred vision again. Her prescription has worsened since her last visit, and her parents are concerned about that.

Start this conversation slowly. “Mrs. Smith, I know that your daughter’s myopia has increased since the last time we saw her. This is kind of normal at this age with her family history and the environmental visual factors contributing to this. But, I wanted you to know that there are contact lenses designed to help slow this process down some.

“I know she is young, but you may want to consider this option in the next year or so. The earlier we start treatment, the better the outcomes are. Let me know when you are ready to go down this path because we fit younger children in our office with these types of contact lenses all the time.”

In Conclusion

The parent conversation is critical to making that move into successful contact lens wear. Having the right timing is key to getting everyone on board with your treatment plan. Lead with the visual benefits, and know when to push hard or tread lightly. CLS

Dr. Miller is in a partnership private practice in Powell, Ohio. He has received honoraria for writing, speaking, acting in an advisory capacity, or research from Alcon, Allergan, B+L, Johnson & Johnson Vision Care, Revolution EHR, and Shire. You can reach him at drmiller@eyecarepowell.com.