Kids & Contact Lenses

Often when I present contact lenses as an option to parents, they may be hesitant and ask whether their child is old enough, and whether it is safe or necessary. Contact lenses are a fantastic option to adolescents, and I believe that we should offer these to all our kids requiring refractive correction.

We are all well aware of the optical benefits of contact lenses – including reduced peripheral distortion, wider field of view, and of course there are the practical benefits such as less chance of slipping or coming off in challenging situations, less susceptibility to fogging and becoming soiled with sweat, rain, dust, etc. These benefits of contact lenses provide patients with convenience and comfort, especially in sporting and leisure activities where spectacles are a nuisance or even a hindrance.

For many adolescents, contact lens wear may provide greater self-esteem and vision related quality of life, 1-4 particuarly those with high prescriptions where spectacles can be thick and unsightly. Spectacles can be uncomfortable and may be impractical for activities such as sport and there is often a stigma associated with wearing spectacles as they may face teasing from other children with name calling such as ‘four-eyes’ and ‘nerd.’ Many will improve confidence and performance in sporting activities and in schooling, particularly when refractive correction is avoided due to discomfort, inconvenience or ridicule from spectacles.

Many believe that contact lenses are not safe for adolescents, however studies have shown that children of all ages are able to wear contact lenses without complications provided they are compliant.4-5 From my own clinical experience, I find that adolescents are often the most compliant of my patients, as adolescents are accustomed to routine and following instructions. They are less likely to stray from the prescribed regime, especially when under the supervision of an adult.

Some parents may argue that their child is too irresponsible for contact lenses as they often lose or break their spectacles.  However, arguably, these are some of these patients that are best suited to contact lenses. Spectacles are rarely lost when worn full time – they usually are lost or broken when taken on and off or when they are not worn at all. Adolescents will resist wearing spectacles due to the limitations, discomfort or teasing they can cause. Thus, adolescents who are highly resistant to spectacle wear are often the most motivated to wear contact lenses as it more attractive than wearing spectacles, and for certain patients contact lenses can be the difference to being uncorrected to fully corrected.

There are many other benefits of contact lenses specific to certain lenses including UV protection (which is important in the Australian sun!), to being able to correct ocular conditions that spectacles are not suitable for such as keratoconus, post-ocular trauma, aphakia, or extreme refractive states. They may also reduce photophobia in cases of albinism, aniridia, polycoria, etc.

As a practitioner, one of the greatest benefits of contact lenses is the ability to retard myopia with certain modalities. Recently there has been much discussion on this epidemic, as prevalence and degrees of myopia has been growing rapidly throughout the world6. Studies have shown that contact lenses have been a safe and effective method for retarding the rate of progression of myopia with ortho-keratology7-8 and soft bifocal contact lenses9 compared to spectacles or no correction. Contact lenses are often the preferred method for these patients and their parents as the side effect of contact lens wear for myopia progression is clear comfortable vision! Myopia progression is not only important to keep children from requiring thick heavy spectacles, but for reducing the risk of ocular conditions such as retinal detachment, myopic maculopathy and glaucoma which are associated with myopia. 6

Contact lens fitting to children and teens can be extremely rewarding, not just for the patient but also for the practitioner. Speaking from personal experience, prescription of contact lenses to these young patients has been one of the most rewarding parts of practice to me.

Some practitioners may be resistant to prescribing contact lenses because of the perceived increased chair time required to fit contact lenses. Studies have shown that whilst the time to complete a new contact lens fit for a patient may be slightly longer in a younger patient, most of increased time is in the insertion and removal training4. In a busy practice, chair time is valuable, however insertion and removal training can be delegated to front of house staff, meaning less disruption to a busy appointment book. Personally, I find these patients some of some of my most loyal patients, and adolescent contact lens fitting has been a fantastic practice builder.

With greater availability of contact lenses and huge advances in technology and expansion of parameters, now is better than any time to be prescribing our adolescents with contact lenses.


- Jessica Chi

As She Dreamed It

Just prior to her thirtieth birthday, Jess Chi fulfilled a goal: to own her own practice. Jess, who graduated from the University of Melbourne in 2007, is now the director Eyetech Optometrists, an independent practice based in Carlton with a strong emphasis on contact lenses. She took over last year from founder Russell Lowe.
“I feel at home,” she says. “It doesn’t even feel like work.”
Jess is a self-confessed contact lens nerd. Her passion for contacts dates back to when she was shy teenage girl who hid behind her glasses. Contact lenses helped her to open up, and she became enchanted. She was proactive in discovering the latest contact lens technology, and even instructed her mother to switch optometrists as her optometrist was not keeping up to date.
“I knew all the contact lenses then on the market in high school, years before I even began Optometry,” says Jess.
Choosing a uni career pathway, Jess knew she wanted a career in health, and optometry seemed the obvious choice.
“I hated going to the dentist,” Jess says, “but I always enjoyed going to the optometrist. I wanted a career where as a practitioner, people actually liked coming to see me.”
‘Contact lenses’ was easily the subject Jess enjoyed the most at university. She was lucky enough to secure a graduate job with Richard Lindsay, a well known contact lens practitioner whose practice is among those who have set the pace for contact lens work in Melbourne. Her enthusiasm and excitement for contact lenses was obvious, and it was this that landed her the job.
Here, under the close mentorship of Richard Lindsay, she learnt anything and everything about specialty contact lens fitting and management of the anterior eye – from basic contact lens fitting to complicated rigid, hybrid, mini-scleral and ortho-keratology fits for all conditions including keratoconus, post-surgical and paediatric aphakia. Most of the topics were taught in university, however students were lucky to see these patients in clinical training, so it was a steep learning curve for Jess, but one she embraced wholeheartedly.
Jess says her interest has given her access to collegiate world: you meet another contact lens practitioner, says Jess, and you form an “instant bond”. She notes the group of optometrists practising largely or mostly in contacts are also cooperative and happy to share information and refer patients.
In fact, she never thought she would love her profession as she did. “My friends refer to me as the annoying one that actually loves their job.”
After several years in her graduate job, it was time to branch out, and she was keen to expand her skills and experiences. She considered whether an industry position would for her. But she realised she loved the patients, and the knowledge of the positive impact she could make in their lives and she knew she wanted to continue being a hands-on clinical practitioner. She realised she wanted own practice, and after discussing this with colleagues, she was pointed in the direction of Russell Lowe and Eyetech.

This story was originally written by Kristy Machon and first published in April 2015’s edition of Scope, the bimonthly magazine of Optometry Victoria.