Children have some unique vision and eye needs. In addition, it is very common for them to experience a phenomenon refered to as "myopic creep." Due to their highly active and interactive lifestyle, there is also increased concern with respect to eye safety.
Are Your Children Ready For School?
Knowing Letters Isn't Necessary
Your Child's Adaptability Can Hide A Vision Problem
A School's Or Pediatrician's Screening Is Not A Comprehensive Eye Exam
Contact Lenses Benefit Children
Contact Lenses Can Be Therapeutic As Well?
Who Are You Calling A 'Myopic Creep'?
High Prescriptions Create Problems
Myopia Creates Health Risks For The Eye
Is Controlling Myopia Possible?
Review Current Orthokeratology Studies
Additional Contact Lens Advantages
Time To Consider Contact Lenses
Your children are going to school and they have books, pencils, and backpacks, but do they have all they need? A child’s visual system is responsible for eighty percent of what they learn, and therefore, a visual system that is not functioning properly, will significantly interfere with their normal learning process.
“How old should my child be for their first comprehensive eye exam?” The American Optometric Association guidelines recommend a first exam to evaluate vision and health, be done at age six months. Assuming no problems are found at that examination, a child should be re-examined at three years of age, and once again just before starting school. If the child is at risk or problems are seen then the examination schedule is more frequent.
Almost always when I tell parents this recommended examination schedule, the question I am then asked is “but my child certainly cannot read letters yet - how can you examine them?” Well, you got me! The secret is out of the bag now! In addition to the health evaluation done during the comprehensive eye examination which requires no responses from the patient, we eye doctors don’t really need you to read the letters to perform our visual assessment examination. In fact, we can determine your prescription without any response from you at all - and we do it all the time. The only reason we ask you to read the letters is because that gives us some additional information that can guide our decision making process.
It is sometimes difficult for parents to identify vision problems in their child since children are very adaptable. First, no child will ever complain that they can’t see. They don’t know what clear vision is supposed to look like and so they do the best they can with what they see. They don’t know that everybody isn’t seeing the same way that they are seeing. Second, if one eye doesn’t see very well but the other one does, they can appear on the surface to be functioning normally. Third, children typically have their own agenda. What this means is that they may want glasses because one of their friends just got glasses or they may not want glasses even if they can’t see well for fear of being made fun of by their peers.
There are three main parts to a child’s comprehensive eye examination. Vision testing which determines whether there is a prescription and how well they see. Binocular testing which determines how well the two eyes work as a team to give comfortable non-strained vision. Health evaluation to determine if there are any medical problems (i.e. glaucoma, etc.) with their eyes. It unfortunately is a common misconception that a school screening or a pediatricians vision check, are sufficient to determine these things when in reality, the screening is not even testing for these things. A screening is only designed to identify extreme problems and in no way replaces the need for a comprehensive eye examination.
Can kids really wear contact lenses? I don't think that my child is old enough or responsible enough to wear contact lenses. If my child can't even keep their room clean, how are they going to be able to take appropriate care of contact lenses? What is the proper age to consider contact lenses for children? Are these some of the concerns that you may have in correcting your child's vision with contact lenses? You are not alone. I find that these are the most commonly asked questions by parents after I suggest contact lenses for their children. Let's answer these questions one at a time.
How young is too young? Actually, there is no age that is too young for contact lenses. There are many instances requiring that even infants be fit with contact lenses. In my personal experience, children between the ages of four and six years of age are generally mature enough to be self-sufficient in caring for their contact lenses. These children do very well and really take excellent care of their lenses. They seem to understand that wearing contact lenses is a privilege and that they have been given a very "adult" responsibility.
So what does keeping a room clean have to do with wearing contact lenses? Actually, absolutely nothing. Keeping a room clean may be beneficial but usually not for the child. The untidy room could represent anything from rebellion to laziness but rarely will indicate how well a child will do with contact lenses. The benefits of contact lenses to children in addition to providing excellent vision and freedom in activity, are increased self-esteem and self-confidence. Their whole image is enhanced. On many occasions I have seen shy, reserved spectacle wearing children come out of their shell after beginning to wear contact lenses. Children have a strong desire both to "fit in" as well as feel special. Contact lenses address these issues very well because the child's vision correction is "invisible" to their peers and lenses are truly a special privilege.
In addition to what has already been mentioned there is also a therapeutic advantage to contact lenses and nearsightedness. There has been overwhelming study data to show that wearing special contact lenses is the most effective visual correction method at slowing or halting the progression of nearsightedness (Orthokeratology). With the nearsighted prescription increasing there is an increase in the dependency on the correction being worn in addition to increasing health risks for the eye. Slowing down or stabilizing the advancing prescription can have the added benefit of allowing the continued function of certain activities without correction as well as avoiding the helpless feeling very nearsighted people have when they are not wearing their prescription. Even more importantly, it reduces the health risks for the eye.
Do you remember as a child, every year you would notice that your vision was not as good as before since the lights had haloes and you would have to squint to see things more clearly when they were far away? Every year you received the sad news that you needed a stronger prescription and that your glasses were going to be even thicker than before. You asked if it was ever going to stop getting worse or would it just get so bad that you eventually would be blind? The continued worsening of distance vision comes from increasing myopia (near-sightedness) and is referred to as 'Progressive Myopia' or 'Myopic Creep.'
As you may remember, the more near-sighted you became the more difficult it became to do even some of the simplest things without wearing your prescription. Watching television, being able to identify who the person is that is coming toward you, or just making your way on the beach back to the people you came with after going for a swim. Of course, operating your car is impossible without your prescription. When the prescription increases high enough, even walking around the relatively safe environment of your house without your prescription becomes dangerous. The dependency on the prescription increases dramatically and with this comes the feeling of being 'handicapped' or helpless when not wearing the correction.
Myopia, by most people, is considered a 'benign inconvenient nuisance,' that doesn’t allow normal visual function without the aid of appliances (spectacles and contact lenses). It certainly is true that it is inconvenient, but by no means is it “benign.” Unfortunately, myopia also brings increased risk for much more devastating and potentially blinding conditions such as Glaucoma and Retinal Detachment. Depending on the amount of myopia present, the increased risks for these serious conditions are alarming. For example, myopia 6.00 diopters or greater increases the risk for cataract by 5 times, the risk for glaucoma 4 times, and the risk for retinal detachment 16 times. A recent study showed that just by reducing the final level of myopia that the eye reaches by 1.00 diopter, decreases the risk of myopic maculopathy (the most serious blinding complication of myopia) by 40%. With risks for permanent vision impairment this high, controlling the progression of myopia should be the top priority in eyecare for children.
Are you seeing history repeat itself through your children? Are their glasses already being worn full-time and the loss of their freedom from a prescription been realized? The question I am always asked by parents is if there is anything that can be done to slow down or stop myopic creep. This has been and continues to be investigated thoroughly with various strategies and the vision correction method that has been shown to be most effective and safe is having the person begin Orthokeratology (special contact lenses worn only during sleeptime).
It has been known for many years that people who began wearing firm contact lenses seemed to have no change in their prescription. Although this was anecdotally reported to be a successful method of controlling myopia progression, when it was formally studied it was shown to be largely ineffective. However, simultaneously many formal studies looked at the effectivity of Orthokeratology treatment using these very same firm contact lenses that were designed very differently, and the results were impressively effective. Orthokeratology is a procedure that uses specially designed contact lenses to actually reduce the myopia. In most cases the reduction is complete so the person no longer needs to wear any optical correction devices to see clearly for any of their daily activities. OrthoKeratology brings back the freedom from the dependency on the prescription. Orthokeratology treatment has proven itself in multiple studies to be safe, easily accepted, and the most effective vision correction method to slow or halt the progression of myopia. Since myopia has reached epidemic proportions worldwide, and continues to increase, many myopia control studies are ongoing. You can read a summary of some of these studies right here Review Current Orthokeratology Studies Bringing the ability to control myopia progression to the public’s attention will be of great benefit to many people, as well as society. Please read more about Orthokeratology in the "Related Links" section below.
The benefits of Orthokeratology are obvious. It is safe, effective at slowing or halting myopic progression, and provides normal clear vision all day long without the need to wear any optical appliance for vision correction. However, even day wearing rigid oxygen permeable contact lenses still have many benefits above and beyond spectacles. They; are very healthy, are easy to maintain, are easy to handle, provide superior vision, have excellent long-term comfort, are durable and very cost effective. Parents also are very suprised when I recommend contacts for children, but because contacts can provide so many benefits to this age group, I will routinely fit children four years and older into contact lenses.
Has your child already asked about contact lenses? Are you concerned about myopic creep and are interested in the possibility of slowing, halting, or even reversing the advancing myopia? Have you been considering contact lenses for your child but have been afraid that they are too young. Join the many parents who have been absolutely amazed at how well their children have done in contact lenses.
The following videos are all candid comments from actual Orthokeratology patients.
Dr. Maller Orthokeratology Webinars.
From the Orthokeratology Academy of America.