Why fit children with contact lenses?

Parents often report that another eye-care practitioner (ECP) said children should not be fitted with contact lenses before the age of 12. But children as young as 7 or 8 years old should routinely be given the option of contact lenses for refractive error correction.

Children often participate in a variety of after-school activities. Contacts can provide them with more convenient vision correction. Glasses don't fit well under helmets and they may not stay on a child's face during gymnastics or cheerleading. Besides the inconvenience, children with low refractive errors frequently lose or don't wear their glasses. Rambunctious children also mangle their frames on a regular basis, so contacts may prove to be cost-effective. For moderate to high hyperopia, contacts can be cosmetically more appealing than glasses and they are likely to be more comfortable. Young children may also be called "four eyes" or "nerd" because they wear glasses, which can make them self-conscious.

Until the early studies are substantiated, we should only tell our patients that they may benefit from slowed myopia progression with corneal-reshaping contact lens wear, but we don't know for sure.

Overview of contact lenses

The potential benefits of contact lenses are clear, and a variety of contact lens modalities are available for children. Studies have shown that children are capable of wearing frequent-replacement,^4,5,9,10 daily disposable,¹¹ gas-permeable,^2-4,12,13 and corneal-reshaping contact lenses.^6,14

One consideration when deciding what type of contact lens to recommend for a child may be the type of contacts that a parent wears. Most parents wear frequent-replacement contacts, and the experience may help the child in times of distress. Frequent-replacement contacts are cost-effective, available for the correction of most refractive errors, and they may be used with multi-purpose contact lens solutions. Approximately 93% of children who try them will wear frequent-replacement contacts for at least 3 years.⁵

The primary disadvantage of frequent-replacement contacts is overwear. Children don't dispose of their contacts on a regular basis, and they may not remove them at night. Children should replace the lenses on the first and 15th day of every month and be constantly reminded how to care for contact lenses by parents and ECPs.

Daily disposable contacts do not have to be cleaned, and children can simply throw their lenses away at bedtime. This fact becomes abundantly clear when vacuuming the carpet near a daily disposable contact lens wearer's bed. Daily disposable contact lenses cost more than frequent-replacement contacts, but parents often choose convenience over cost.¹¹