Contact Lens Business
Kids, Parents and Contact Lenses
Getting kids into contact lenses can be both tricky and rewarding. Here's advice from an experienced technician.

Remember when kids started wearing contact lenses at 16 to 18 years of age? Anyone younger was considered too young, except for the rare medical case.

Today, practices regularly fit much younger children. In a pediatric ophthalmic practice, the age can go down to only a few months old when medical problems such as cataracts or anisometropia are involved.

Contact lenses for kids may be a choice or a medical necessity. The kids themselves may want to wear them for sports, for cosmetic reasons, or even because their parents wear them. On the other hand, trauma and birth defects may make contact lenses a necessity for proper vision development. Fortunately, with the availability of so many different types of contact lenses, you can meet a child's needs, whatever they might be.

Of course, having the right contact lens is one thing. Successfully managing the young patient -- and the parents -- is quite a different matter. Here, I'd like to offer some advice for dealing with kids and their parents when fitting the kids with contact lenses.

To help get younger kids to cooperate during the fitting:

• Keep talking to them. This is a key to holding their attention.
• Explain what you're doing as you go along. Many practitioners assume young kids won't understand, and don't bother trying to explain what's happening. In my experience, kids understand just fine. In fact, if you make no effort to explain, they tend to be uncomfortable and less cooperative.
• Make following your instructions a game. Your young patients will be happy to tell you all the colors they see in the slit lamp beam. And when you take a K reading, tell them the light is the light on the front of a train; they'll sit very still while they focus on trying to see the train coming.
• If the kids are especially young, have the parent play the game first. If the child sees the parent looking for the train, he'll feel more comfortable doing the same thing.

MANAGING PARENTS

Many parents think of contact lenses as a cosmetic device only. From that perspective, getting their child to wear them is more trouble than it's worth.

Unfortunately, if the parents don't believe wearing the lenses really matters, you won't meet with success (unless you're dealing with a highly motivated child over the age of 4). On the other hand, if you convince the parents that the contact lenses are important, they'll do whatever is necessary to make them work.

You must involve parents early on and keep them involved. Helpful strategies include:

• Make sure the parents understand the reason for the contact lenses. This is essential in order to enlist the parents' support (and prevent them from being an obstacle). To accomplish this:
  • Point out that contact lenses often give a more accurate picture of the world than glasses, and that this contributes to fuller development of the child's vision.
  • Explain that contact lenses offer a cosmetic benefit that can be important to a child's self-esteem, especially when the child's prescription is strong.
  • Make sure the parents understand what's at stake. In many cases, such as when the difference in refractive error between the eyes is too great, glasses can't solve the problem. Contact lenses are necessary if the child is to have binocular vision.
• Explain the reasons in terms the parents will relate to. If you want the parents' cooperation -- and you do --put the situation into a context that they'll understand. For example:
  • Most people have no real idea what 20/40 vision really means. However, if you explain that wearing the lenses will help to make it possible for the child to pass the drivers test when the child is older, parents usually grasp the importance right away.
  • Parents may not understand the underlying medical reasons for patching one eye to treat amblyopia, but they understand that good binocular vision makes it easier to hit a baseball.
• If the need is medical, be prepared to deal with parental guilt. If the child has a congenital problem such as cataracts, parents may believe they should have done something to prevent it. Or, if some sort of accident took place, parents often feel guilty. (The parent may also believe that wearing the contact lenses will add to the stress the child has already experienced.)
  Acknowledge these feelings, and let the parents know two things:
  • These are feelings most parents in this situation have.
  • Regardless of what happened in the past, discipline with their child's visual development now will help ensure that their child will have good vision in the years ahead, and help build a better future for the child.
• Keep the parent involved as the child improves. If parents see the benefits of continuing the therapeutic regimen, they'll make sure that the child continues to comply.

SHAPING THE NEXT GENERATION

Getting kids into contact lenses successfully can be challenging, but it's also rewarding. After all, you're helping young people to see their world more clearly. And if you get the parents actively involved, the process will be that much easier. 

Vicky Sheppard is a Fellow in the Contact Lens Society of America. She's fit contact lenses for more than 20 years, and has specialized in working with children for 15 years. She is currently a pediatric contact lens fitter for the Family Eye Medical group in Long Beach, Calif.