“Can my child successfully wear contact lenses?”

It’s a question many parents ask their eye doctor when their kids want contacts. In this month’s Contact Lens Spectrum, Jeffrey Walline, OD, PhD, and Marjorie Rah, OD, PhD, discuss some of the factors associated with the success (or lack of success) children have when attempting to wear contact lenses.

Recent research suggests that more than 90 percent of children ages 8 to 14 can successfully adapt to wearing soft contact lenses. Because of this high success rate, most children who are interested in contact lenses choose soft lenses.

With gas permeable contact lenses (also called GP contacts), it’s a different story. The success rate fitting children with GP lenses is approximately 55 percent. For this reason, Drs. Walline and Rah say more careful screening of candidates for these lenses may be beneficial.

In a study published in 2009, Dr. Walline found that most children who were unable to adapt to contact lens wear tend to stop wearing the lenses within the first few weeks. But is was unclear to the researchers if these children simply chose not to wear the GP lenses frequently enough and long enough to adapt to them, or if contact lens discomfort or other factors made adapting to the lenses impossible, and this was the reason they wore the lenses less than those who were successful.

From their personal experience fitting children with contacts, the authors have found that children who are squeamish about having their eyes or eyelids touched by their doctor during an eye exam are less likely to succeed with contact lens wear. Children with small eye openings, poor dexterity or poor hygiene also are less likely to wear contacts successfully.

Parents also are a factor in a child’s success wearing contacts, according to the doctors. Parents who are involved without being overbearing offer the best support environment for their kids to wear contacts successfully, they say.

Dr. Walline is an assistant professor at Ohio State University College of Optometry, where he conducts studies of pediatric contact lens wear. Dr. Rah is a staff optometrist at the Massachusetts Eye and Ear Infirmary Contact Lens Service, where she specializes in medically necessary contact lenses and advanced contact lens designs.

In this month’s issue of Contact Lens Spectrum, editor and contact lens specialist Jason J. Nichols, OD, warns that current economic conditions may be affecting how people are wearing and caring for their contact lenses.

Dr. Nichols says hard economic times can alter people’s behavior regarding their health, including how frequently they replace their contacts and how they use contact lens solutions.

“I am hearing more and more reports of patients looking for the cheapest ‘bottle’ on the shelf, which just happens to be saline rather than an appropriate care solution,” he says. Many contact lens wearers may also be using their lenses for longer periods of time rather than discarding and replacing them according to the schedule their optometrist or ophthalmologist recommends, according to Dr. Nichols.

Internet blogs and social networking sites may be contributing to the problem: some sites feature discussion boards where contact lens wearers report how they routinely wear their disposable contacts longer than recommended.

Dr. Nichols warns that poor contact lens habits frequently lead to contact lens-related eye infections, including severe infections like Acanthamoeba keratitis. He urges eye doctors to continue educating and re-educating their patients about proper contact lens wear and care.

In a related story published in the journal, a survey released by the American Optometric Association indicates 52 percent of consumers are visiting their eye doctor less frequently due to economic reasons. The same survey says 59 percent are visiting their primary care physician less frequently.

In a new survey, more than half of parents with children ages 8 to 17 who currently need vision correction say their child is interested in wearing contact lenses.

But nearly one-third of those parents have never considered contacts for their child, and another 27 percent haven’t considered it seriously.

The results are somewhat surprising, given other findings of the survey: Parents of kids who currently wear prescription eyeglasses say their child doesn’t like wearing glasses (42 percent), doesn’t always wear them when he should (41 percent) and sometimes feels self-conscious wearing them (40 percent).

The two main reasons parents gave for not being more proactive about contact lens wear for their children: a belief that eyeglasses are easier to clean and care for than contacts (77 percent) and concern about their child’s ability to take proper care of contact lenses (54 percent).

Recent studies, however, demonstrate that most children are capable of caring for soft and silicone hydrogel contact lenses, and wearing contacts may improve a child’s self-perception, especially among girls.

The survey was conducted on behalf of Johnson & Johnson Vision Care, Inc., the manufacturer of Acuvue brand contact lenses. A full report of the survey can be found on the company’s website.

At least 60 percent of contact lenses prescribed in the United States are silicone hydrogel contacts or daily disposable contacts, according to a recent study conducted by the Centre for Contact Lens Research (Ontario, Canada).

The researchers surveyed 158 eye doctors regarding the types of contact lenses they prescribed for a total of 1,654 patients. The survey was part of a larger study designed to assess patient and eye care practitioner compliance with recommended replacement frequency of contact lenses.

The study found:

• Silicone hydrogel lenses were prescribed for 45 percent of patients and daily disposable contacts were prescribed for 16 percent.
• A very large majority of the contact lenses (92 percent) were prescribed for correction of myopia.
• Toric contact lenses for astigmatism were prescribed for 16 percent of patients and multifocal contacts were prescribed for 3 percent.

Also, 12 percent of patients reported wearing their lenses overnight as extended wear contacts. Even among patients wearing daily disposable lenses, 19 percent reported wearing their contacts overnight occasionally, frequently or almost every night.

Source: What contact lens materials are patients wearing? Contact Lens Spectrum. August 2009.