University of Iowa Health Science Relations and
Christine Sindt, O.D.
Assistant Professor of Ophthalmology & Visual Science
First Published: 2002
Last Revised: September 2004
Peer Review Status: Internally Peer Reviewed

Children may benefit from contact lens wear more often than we think. Children often want contacts for many of the same reasons adults do, including appearance, comfort and improved vision.

Children's vision is constantly developing, and contacts give a more "real" or less distorted view of the world. Contact lenses can balance the image from both eyes, and correct any irregularities or astigmatism of the eye. Some studies have also shown that progression of nearsightedness can be lessened by contact lens use. Contacts are an excellent option for the budding athlete as well.

Contact lenses are designed to fit each individual, no matter what age, so fitting your child should be no more difficult than fitting an adult. Your eye care provider can help you make an informed decision as to whether contacts are right for your child.

It is important to know whether your child is suited for contact lenses. Indications may include medical or cosmetic reasons, whereas eye health, cost, allergies, and parental responsibilities may indicate that contacts are perhaps not best for your child. There are some risks involved in lens wear, including infections, allergic reactions, and eye dryness, redness or irritation. The only sight-threatening risk of contact lens wear is corneal ulcers. However, by staying with the prescribed care regimen and having good follow-up and communication with your eye care provider, most complications are rare.

Christine Sindt, O.D., director of the Contact Lens Service in the UI Department of Ophthalmology and Visual Sciences, points out that "motivation is everything." In the absence of a medical requirement, a child must have a desire to wear contact lenses. At the same time, parents have to be motivated to monitor and/or care for the child's contact lenses.

For younger children, parents will have not only the responsibility of cleaning and caring for contact lenses, but also possibly insertion, removal, and inspection of the lenses themselves.

"It's important for parents to understand what to expect and how to manage their child," Sindt said. "In some cases, young kids aren't able to verbalize problems they may be having with their contacts. Parents must know when it is important to be calm and when to call the doctor."

Kids can be fitted with contacts when they are just days old, for medical reasons. Cosmetic fits can be done as soon as a child is old enough to verbalize his or her desire for contacts. By age 5, children are able to take contacts out on their own; by age 6 they are able to put them in. If parents do not want to be involved with taking care of their children's contacts, Sindt recommends starting a child on contacts around age 10.

Many contact lens options are available. Types of lenses include rigid gas permeable, soft and continuous wear lenses. Gas permeable lenses may reduce myopic progression (development of nearsightedness), produce better optics, are easier to handle and last longer than other lenses. These lenses may have initial lens awareness and higher up-front cost.

Soft lenses fall into four categories.

• Conventional soft lenses: Seldom used today, secondary to cost, long-term comfort, increased complication rate, and rigorous cleaning involved. These lenses are typically replaced every six months to one year. Today, conventional soft lenses are used only when a custom-made lens is required.
• Disposable lenses: Generally replaced on a two-week basis. The lenses are removed and cleaned nightly. The frequent replacement schedule of these lenses minimizes the care steps and reduces lens spoilage.
• Daily disposable lenses: The easiest and safest of the standard plastic lenses. A new sterile lens is inserted each day and thrown away upon removal. They require no care and no cleaning.
• Continuous wear lenses: 30-day continuous wear silicone-hydrogel lenses provide safe, effective and comfortable vision correction without removing the lenses for a month. Unlike any other contact lens material seen to date, silicone-hydrogel lenses are hyper-oxygen permeable and have minimal pathogen binding to the lens surface or cornea. Minimal care is needed to maintain these lenses, since they are replaced with a fresh lens upon removal. This results in healthy corneas and less infections.