CONTACT LENSES FOR TWEENS

Not too long ago, the mention of contact lenses for children (8 to 14 year olds) was not very common, but today contact lenses for children is more commonplace and a simple search of this topic on the internet yields more than 600,000 hits. Significant changes in both technology and the expectations of this age group are the reasons for the increased interest in this area.

'Tweens' (8 to 14 year olds), are clearly beginning to develop a sense of identity and aim for a sense of sophistication and adultness. A glimpse of the life of the modern day tween suggests that they are more independent and adult-like than their counterparts from decades ago and are more likely to reach out for products that enhance their body-image and self-worthiness. Today's tweens are technology-savvy, are more likely to own or at least have access to a mobile phone, have access to the internet, and have visited foreign places. Tweens are readily influenced by branded products, are likely to have access to their own money and are also likely to influence their family's decision on any given issue.

Refractive error is the main reason why the majority of tweens would want to wear contact lenses, and clearly, there are factors associated with wearing contact lenses that also build the sense of sophistication that tweens are looking for. Contact lenses are a convenient form of vision correction for sporting and active lifestyle activities, and are far more cosmetically appealing than spectacles. Indeed contact lenses are an excellent option for children who are concerned about their appearance with spectacles.

One survey from the USA examining the trends in contact lens wear in 2000 indicates that 60% of people start contact lens wear before the age of 20, with the median age being 17 years.¹ The same survey indicates that the minimum age for beginning contact lens wear as a form of vision correction is getting younger. In 2000, 28% of contact lens wearers began wear before the age of 14 compared with 13% in 1992 (Figure 1) and a more recent report shows that this vision correction modality is still growing in the younger age groups, extending to the pre-teens.²

In a survey conducted in 2003 by the Cornea and Contact Lens Research Unit, 20 established practices from Sydney, Australia were queried as to whether they fitted contact lenses in children less than 10 years of age or between 10 and 14 years. While only 50% of the practices had fitted children less than 10 years of age, all practices had fitted contact lenses in children aged between 10 and 14 (Figure 2).

Are we missing anything?

Although there are many scientific studies that have focused on the performance of contact lenses in adult wearing eyes, there are no equivalent studies evaluating the performance of contact lenses for vision correction in teens and pre-teens. Studies conducted in Asia and the USA that have evaluated primarily rigid gas permeable lenses for their effect on progression of myopia clearly indicate the capability of children for wearing contact lenses^4-7 and anecdotal evidence suggests that if a child is motivated and conscientious, then their experience with contact lenses is likely to be a success. At our center, we find that contact lenses, including silicone hydrogels, designed primarily for adult eyes can be fitted on children as young as 7 years of age. It is likely that many of the factors that comprise successful lens wear in adults are similar to those in children, although other factors such as their level of maturity and family attitudes will also play key roles. Well-conducted research into the factors that influence successful lens wear in children is needed to help manage this burgeoning sector wisely.

The advantages that silicone hydrogel lenses offer can go a long way in making a child's experience with lens wear a success. Silicone hydrogels have the comfort of a soft contact lens, are easily handled and don't break. They are available for the majority of myopes and for hyperopes up to +6.00 D. Although originally designed for continuous wear, silicone hydrogels are well suited to daily wear, and the high oxygen transmissibility that these lenses deliver means that children can wear these lenses for years without developing any of the long-term physiological effects of hypoxia.

Contact lenses for tweens are here to stay. As practitioners we must offer children the widest possible choice of vision correction that best suits their individual personalities and needs. This is not only for the benefit of the patient, but also for the practitioner. A child that is comfortable and confident with contact lens wear may choose to continue with contact lenses into adult life. So, the next time a tween steps into your practice, think about whether they would benefit from contact lenses and consider giving them the option. Remember also that they may be a contact lens wearer for many decades to come, and they need the best physiology that we can provide.

References

1. Trends in Contact Lenses and Lens Care. Bausch and Lomb Annual Report to Vision Care Professionals . Dec 2001
2. Specialty Lenses and Favorable Demographics Are Driving Growth Worldwide . Market watch - Optical Sector Report: Contact lens report. Nov 2002; www optistock.com
3. Growing Australian Contact Lens Market Database: 2003, Vision Cooperative Research Centre, Sydney Australia
4. Katz J, Schien OD, Levy B, Cruiscullo T, Saw SM, Rajan U, Chan TK, Yew Choo C, Chew SJ. A randomised trial of rigid gas permeable contact lenses to reduce progression of childrens' myopia. Am J Ophthalmol. 136(1), 82-90, 2003.
5. Walline JJ, Jones LA, Mutti DO, Zadnik K. Use of a run-in period to decrease loss to follow-up in the Contact Lens and Myopia Progression (CLAMP) study. Cont Clin Trials. 24(6), 711-718, 2003.
6. Khoo CY, Chong J, Rajan U: A 3 year study on the effect of RGP contact lenses on myopic children. Sing Med J. 40(4), 230-237, 1999
7. Perrigin J, Perrigin D, Quintero S, Grosvenor T. Silicone acrylate contact lenses for myopia control: 3- year results. Optom and Vis Sci. 67 (10), 764-769. 1990