Contact lenses can be successfully fitted to children and young people from an early age. For medical reasons, this could be as young as two or three years old. There is certainly no need to wait until the eyes stop changing and there is good sense in letting youngsters get used to lenses soon after they begin to need spectacles.
For routine correction of vision, children can be very successful as young as 6 or 7, although 10 to 12 years is a more usual age to consider fitting. The following criteria should apply:
- Spectacles need to be worn all of the time.
- The child wants to wear lenses or is reluctant to use spectacles.
- Parents are happy for the child to have lenses.
- Old enough to understand the handling, maintenance and hygienic aspects of contact lens wear.
All of the above are assisted if parents wear lenses as an example and they may initially help with handling and general supervision. Ideally, children should be able to insert and remove their own lenses from the beginning or fairly soon after fitting.
Eye shapes are usually fairly similar to those for adults and the same range of lenses is therefore available. Regular checkups and aftercare are essential because of the potential number of years lenses may be worn and materials with the best physiological characteristics should be used such as the modern silicone hydrogels.
The advantages and disadvantages of the various lens types are mainly similar to those for adults. Most youngsters will probably prefer soft and daily disposables are the ideal lenses with which to start because there are no concerns about loss or damage and they are ideal for sports. Long sighted eyes almost invariably find soft considerably more comfortable.
Hard gas-permeable lenses are still a possible first choice for short sighted children because they may slow down any increase in prescription. There is now evidence that modern orthokeratology (OVC overnight vision correction) also seems to stop short sight from progressing.