At What Age Should Contact Lenses Be Considered for Children?

Implications: A recent study showed that children aged 8-12 were just as successful as teenagers aged 13-17 in the areas of physiological adjustment and contact lens care.  I find this is true in my practice as well.  Not only can prescribing to this younger demographic change a child's life, it can also increase an Eye Care Practitioner's bottom line.

Analysis: My personal philosophy on prescribing contact lenses for children is based on the child's maturity level, rather than age.  I've found that children have a very wide range of maturity levels, even though their ages may be the similar.  If I determine a child may be a good candidate for contact lenses based on their prescription and my assessment of their maturity level, I'll introduce the idea to both the child and the parent at that exam.  I'll actually take a trial lens out and put it in the child's hand and let them touch it so that they get a better understanding of the concept.  Depending on both their reactions, I assess if it is an option to pursue now, versus one that they can discuss on their own, and then I'll bring it up again at their next exam.
 
The first lens I consider for a child is a daily disposable lens.  There are less steps to follow for both parent and child when the child can just throw the lenses out at night.  No cleaning, no solutions, and no keeping track of when 2 weeks, or a month is up.  What 8 or 9 year old child has an accurate concept of time?  Also, I have several children who are on their school swim teams.  Once they are done their swim, they can just throw the contacts out after getting out of the pool.

The social impact at school for a child who is embarrassed about wearing glasses can be devastating.  Put contact lenses on that child and it can literally change their lives.  I have one patient in particular that stays with me.  He was a 10 year old with -5.00DS OU, and was very introverted and quiet at his first exam.  I convinced him to try contacts and he took to them like it was meant to be.  At his followup a couple weeks later, he was a different boy.  His Father reported a complete change in his personality; he was more outgoing, more social. and came out of his shell.  It sounds cliche, but contacts changed his life.

One more aspect that should be addressed when considering prescribing to younger patients, is the potential financial gain for the Eye Care Practitioner.  When you open up a service to a new demographic, you stand to make more money.  And who doesn't like that?  There may be slightly more chair time involved initially, but if you become effective at qualifying the child as a good contact lens patient, and delegate the training, everyone should be rewarded.