Welcome to question of the day #172

Eyetools question of the day #172

One of my patients has a son who is very keen on football and plays in goal. He is almost 12 years old.  He plays several times per week has the potential to go onto a high level. He has -1.00 DS myopia in each eye and does not wear or want to wear contact lenses. He is fearful of putting them in and can’t bear to watch his mother put her contact lenses in. During football matches, he has noticed that his reactions are slow for balls coming in from crosses and long-range shots. His coach has confirmed this. He has glasses for school work. What can I do?

It is very common for some people to be fearful of contact lenses and of putting them in their own eyes. In my experience, 90% of people considering contact lenses are fearful of them and the process of putting them in and taking them out.

This young man would be a good candidate for soft contact lenses. He might still be in the age range where dual-focus myopia management soft contact lenses, just so it is worth having this conversation.

Otherwise, start him on daily disposable soft contact lenses. His aversion to watching his mother put her contact lenses in my experience can be overcome. I have seen many times people who are averse to ‘touching’ their eyes quickly learn how to put them in. They tell me that somehow it looks worse when someone else is putting contact lenses in than when they handle, insert and remove their own contact lenses. What is needed is a tutor with patience, time and a private quiet area in the practice. It may be that it takes two or more appointments to master the techniques but persistence will prevail. Make sure his nails are short and kept clean and that he washes his hands before handling his lenses.

Good research has shown that patients aged 8-12 are less likely to have contact lens-related eye problems than teenagers.

Another good motivator will be the increased clarity of vision during games, resulting in more confidence and a better goalkeeping performance. As his game improves, he will be even keener on his lenses and soon his fear of them will fade away.

It will be important to make sure his hands are very clean when he removes them after a football match and to have regular reviews to check the health of the anterior eye and on his insertion and removal techniques. Also, check his nails and his hand hygiene.

It is my experience that young people who have a sport or other activity to motivate them make excellent contact lens wearers.