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Ask the Pediatrician: Should my child get contact lenses?

Douglas R. Fredrick MD, FAAP, American Academy of Pediatrics on

Published in Health & Fitness

Stylish frames and tinted lenses have made eyeglasses more fun to wear. Even so, your child might want to switch to contact lenses at some point.

How can you decide if they're ready for contacts? What healthy routines will they need to learn to prevent eye infections and other complications?

For children with poor vision caused by refractive errors (problems with focusing), glasses are often the first choice. But many young people who play sports, might prefer contacts, since they don't break or fall off as easily as eyeglasses. In some cases, eye doctors may recommend contacts to slow the progression of nearsightedness in children aged 8 to 12.

Contact lenses are thin, clear plastic discs that float on the tear film in your child's eye. Like eyeglasses, they correct blurry vision that happens when the eye does not bend or focus light properly. Contacts can be used to correct nearsightedness (myopia), farsightedness (hyperopia) and distorted vision due to astigmatism ("football shaped eyes").

There are two types of contact lenses your eye doctor might recommend: soft contact lenses, which are flexible and foldable, or rigid gas permeable contact lenses, which are made from stiff plastic that cannot be folded.

While rigid gas-permeable lenses are a good choice for children with high amounts of astigmatism, most children prefer soft lenses for comfort and convenience.

Daily wear contacts can be put in when your child wakes up and stored or even tossed away at bedtime. Extended wear contact lenses (lenses you can sleep in overnight) also are approved for use, but most ophthalmologists do not recommend them. This is because extended wear lenses are associated with a higher risk of eye infections that can cause permanent damage to vision.

Most eye care professionals agree that children as young as 8 years old can safely use contacts lenses. By this age, children can learn care routines that prevent eye infections and other concerns relating to contacts.

Your child may be ready for contact lenses if they can easily follow directions and build new skills; do daily tasks without reminders; learn to keep lenses clean; follow a regular wear schedule; and handle lenses carefully so they don't break or tear.

Contact lenses do come with certain risks. The most common concerns are eye infections such as keratitis. With keratitis, the cornea—the clear, dome-shaped surface of the eye—becomes infected. Keratitis can scar your child's cornea, harming their vision.

Children who wear contacts can also develop conjunctivitis, or pink eye. This happens when the blood vessels in the membrane that lines the eyelid and eyeball become swollen and irritated.

A few simple steps and routines can reduce the chances your child will develop serious eye problems from contact use.

Wash hands with soap and water and dry thoroughly with a clean towel before touching your contacts. Don't sleep in your contacts unless your eye doctor approves you for extended-wear contacts.

Keep your contacts away from water​. This includes bottled, distilled or tap water, as well as lake, river or ocean water.

 

Take your contacts out before swimming or hanging out in a pool or hot tub.

Disinfect your lens case every day or every time you store your lenses.

Dry out the contact lens case with a clean tissue before refilling with fresh solution. Never just "top off" the old solution in your lens case, since this can allow bacteria to linger and grow.

Never use saliva or plain water to clean, wet or store your lenses.

Replace your lenses as often as your eye doctor recommends.

Replace your lens case every 3 months or as often as your doctor recommends.

Since contact lenses can easily be lost or torn, it's smart to keep a pair of regular glasses on hand. This way, your child will be able to see well during school, sports practice or other activities while new lenses are on order.

Tell your children to ask for help if they experience eye pain or discomfort, excess tearing or eye discharge, unusual sensitivity to light, itching, burning, swelling or grittiness, or blurred vision.

Your child should not wear their friends' contacts or loan theirs to anyone else. Sharing contact lenses can raise the chances of infections that can cause serious vision problems. Decorative contact lenses like those sold online during Halloween can harm your eyes. Only wear contact lenses prescribed and dispensed by your eye care professional.

Children should also protect their eyes when wearing contacts by wearing sunglasses when in windy, dusty conditions. Also, use protective eyewear with the contact lenses when participating in sports prone to eye injuries like racquetball, badminton, and ice and field hockey.

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Douglas R. Fredrick MD, FAAP, a pediatric ophthalmologist with Kaiser Permanente South San Francisco, is a Fellow of the American Academy of Ophthalmology and the American College of Surgeons. He also serves on the Board of the American Orthoptic Council as President and Co-Chair of the Examination Committee. Within the American Academy of Pediatrics, Dr. Fredrick is on the Executive Committee as Education Chair in the Section on Ophthalmology. Dr. Fredrick has served as volunteer faculty on more than 20 missions with Orbis, an international non-profit organization that improves access to eye care.


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