EyeWitness

Spring 2017

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When it comes to fitting your younger patient population with contact lenses, there are specific case scenarios that may come to mind. For instance, it is com- monplace to utilize materials of highest oxygen permeability when prescribing a contact lens for the management of pediatric aphakia. It is also not uncom- mon to use occlusive lenses via opaque tints and/or high plus powered lenses for penalization in amblyopia therapy. In addition, cases of where anisometro- pia is the amblyogenic factor, we know from Optics 101 that contact lenses will reduce associated anisokonia in compar- ison to spectacle use. There are also potential oppor- tunities for children who present for eye exams where the use of a contact lens may not be so apparent. Before we discuss some of these categories, let us first review a few of the common ques- tions associated with fitting the pediat- ric patient with contact lenses. ARE CONTACT LENSES SAFE FOR KIDS? Whether they are infants, children, or teenagers, maintaining safety in pedi- atric patients is of the utmost impor- 20 CLSA EyeWitness Spring 2017 Contact Lens Opportunities in Pediatric Populations CE Contact lens fitting in children can be extremely rewarding for both practitioner and patient, as it can be the building blocks for a lifetime of successful contact lens wear. Stephanie Ramdass, OD tance when it comes to contact lens wear. These young patients may not fully understand the repercussions if misuse is practiced. Even if they do understand, there is always the chance they may not be responsible enough to comply. To date, the pool of studies that have looked at the safety of con- tact lens wear in children is sparse. This is not due to lack of effort on the part of today's research community. Most minors are in fact excluded from many clinical trials and US Food and Drug Administration (FDA) post-mar- ket surveillance studies due minimum age requirements to participate. So, what do we know? The abil- ity of young patients to successfully wear contact lenses has been well doc- umented in studies where informed consent was appropriately obtained for the minors involved. These include prospective, randomized studies which show that children as young as 8 years of age have successfully worn contact lenses for multiple years consecutively and reportedly up to 11 hours per day 1 . The incidence of significant adverse events associated with contact lens wear has been low when reported 1 . On the flip side, outside of a struc- tured research and clinical environment where parents and children may be on their best behavior, a look at emergency room visits for medical device associated adverse events found that contact lenses were to blame for 23% of such occur- rences 2 . Corneal abrasions, conjunctivi-

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