Welcome to question of the day #84

Eyetools question of the day #84

I was often asked this question by parents when I worked in practice. My response then and now is that it’s not about age. There are several attributes a person needs to have in order to become a safe and successful contact lens wearer. Some very young people have these attributes and some old people don’t and never will have them.

In my opinion, these attributes are:

  • The dexterity to be able to handle the contact lenses, to be able to put them in and more importantly the ability to take them out.
  • Be able to recognise contact lens-related problems.
  • Have the self-awareness and confidence to ask someone for help if there are problems, that someone could be a parent and/or an eye specialist.
  • Adhere to the wearing schedule.
  • Adhere to the cleaning regime, if there is one.
  • Adhere to the hygiene regime.
  • Willing to attend aftercare examinations.
  • Understand that continued failure on one or more of the above will result in cessation of contact lens wear. And while this sounds like a threat it gives a very clear incentive to follow the rules.

Some people might summarise these attributes as maturity. In the world of contact lens fitting, I have seen this maturity much more often in young girls than in young boys. There are some teenagers and adults whom I would never fit with contact lenses for fear of an ocular catastrophe.

Common reasons for fitting young children with contact lenses are mainly sport related. It is no fun trying to perform ballet, dance, gymnastics, rugby, football, netball or cricket and many other sorts of activities when wearing glasses. Having significant refractive error and not wearing glasses for these activities will mean not reaching full potential. The youngest child that I fitted with glasses was a seven-year-old girl who was performing ballet at a high level in her age group. She was myopic and struggled to see her instructor during training. I remember clearly how she listened intently to the rules, was quick to learn how to insert and remove (no cleaning as daily disposable) and understood the consequences of not following the rules. Her love of ballet was a very strong incentive. She was content to wear them only for ballet and was content to use her glasses for all other activities of daily living. Her parents were supportive and understood the rules. She did very well with her contact lenses and with her ballet.

However, it is not all about sport. Sadly, some children make sport of classmates who wear glasses and it can be a torrid time for the spectacle wearer. The same contact lens rules apply and unwanted attention in the class moves elsewhere.

I always consider daily disposable contact lenses first as these remove several steps where things can go wrong. However, if the maturity is there I will fit other types of lenses for which a cleaning regime is required. There are some very able and confident young children out there. Don’t hold their age against them; give them a chance.