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HomemieyecareContact Lenses and Teenagers: Are They A Good Fit?

Contact Lenses and Teenagers: Are They A Good Fit?

I always used to dread the moment when a 
parent would ask: “can my child have contact lenses yet?” or even worse: “I want him to have contact lenses”.

I used to avoid the topic of contact lenses (CLs) for teenagers. I was concerned about whether they would be able (or willing) to comply with wearing schedules and hygiene regimes and I was concerned about the time it would take to fit them and teach them.

Over the years however, as the variety of lenses and solutions increased and technology brought us better products, I realised the concerns I had about fitting teenagers with CLs were neither warranted or valid. I have now become I used to avoid the topic of contact lenses (CLs) for teenagers. I was concerned about whether they would be able (or willing) to comply with wearing schedules and hygiene regimes and I was concerned about the time it would take to fit them and teach them.

Over the years however, as the variety of lenses and solutions increased and technology brought us better products, I realised the concerns I had about fitting teenagers with CLs were neither warranted or valid. I have now become a strong advocate of CLs as part of my vision correction strategy for my young patients.
Several studies show that young people can be successfully fitted with contact lenses in about the same time as an adult and they make very good compliant contact lens wearers.

Several studies show that young people can be successfully fitted with contact lenses in about the same time as an adult and they make very good compliant contact lens wearers.

Teenagers Contact Lens Benefits

A study by Jeffrey Walline1 and colleagues at Ohio State University looked at how contact lenses changed the self-perception of eight to 11 year old myopes. They found that the contact lens wearing children felt better about their physical appearance, athletic competence and social acceptance than their spectacle wearing contemporaries. Previous work2 had shown that contact lenses significantly improved the quality of life of children and teenagers, particularly in regard to how they feel about their appearance, satisfaction with their correction, and participation in activities. So it is important that we consider the overall wellbeing of our patients and not just their visual needs as we are in a position to transform a young person’s life.

Vision Correction Option Awareness

The average age at which people notice they need vision correction is 13 years so we have an important role to play during the teenage years in raising awareness and understanding of vision correction options3.
Younger people are more likely to try contact lenses than adults4, but only a quarter of teenagers in the 12 to 18 year old age group have discussed contact lenses with their optometrist. Also, what is somewhat concerning, is that the optometrist only initiated a third of these.

Research tells us that 65 per cent of 12 to 15 year olds who wear glasses are interested in wearing contact lenses4, yet the average age at which individuals start wearing contact lenses is 193.

As practitioners, we appear to be neglecting a significant proportion of prospective patients and subsequently an important opportunity to build practice success. Why is this?

Perhaps the answer is best sought by addressing the three perceived obstacles:

1. “Teenagers are not responsible enough to care for contact lenses”

Teenagers are renowned for their risk-taking behaviour. Like the rest of us they use their experience and knowledge to weigh up a situation and take a course of action. Sometimes they get it wrong. However should we remove the risk and not fit them? Alternatively we could use a regime with a large safety margin and make sure they are well educated in its use.

It is vital a wearer is given ownership of the processes around lens wear and care. This must start right at the beginning of the discussion about contact lenses and should take place with the teenager, not just the parent, although the parent should be included. It is important the practitioner use language and an approach that the teenager can understand. Discuss finance in front of them too so they realise the commitment their parents are making.

2. “Fitting teenagers will take more consultation time”

A study by Walline5 looked at the time taken by eight to 12 year olds and 13 to 17 year olds to learn the application, removal and care of contact lenses. On average the former group took 42 minutes and the latter group took 30 minutes – which is about the same as adults. It showed that the younger age group did not require significantly more time than the older age group over the first three months of lens wear. It can be helpful to train a member of the practice support staff who is closer in age to the wearer, for greater empathy between the wearer and the instructor.

Problems can arise when teaching a teenager, or child, if a parent is present. If the teenager does not succeed the first time this can lead to embarrassment and a feeling of pressure for them. Advice offered by parents could also come across as being condescending. Parent and patient education is key to an effective and timely consultation.

3. “Teenagers are not profitable to the practice”

It is a misconception that younger people do not represent a profitable patient group. As other retail categories can testify, teenagers now wield significant purchasing power and the 12 to 18 year old age group represents an engaged market with an active interest in contact lenses. Teenage patients experience significantly fewer drop outs than many other age groups3, proving that they have the staying power and potential to increase practice revenue, whilst remaining loyal to the practice as adults. Practitioners who fit children also report that once a child has been fitted a spectacle wearing parent who was resistant to wearing contact lenses will convert once they see how well the child had adapted to lens wear.

What’s more, teenagers actually have access to considerable disposable income, both directly and from their parents. The parent, of course, remains the key gatekeeper to their child’s health and finances and with this in mind practitioners should consider a ‘dual patient’ approach by educating both teenagers and their parents on the practical and lifestyle benefits of contact lenses.

Communicating the Benefits

Contact lenses should be mentioned the very first time a child needs vision correction. It could be something along the lines of “Your child needs help in seeing things clearly now, for example the board at school, the television and things in the distance. It is likely that over the few years, as the eyes develop, they will need slightly more help and need their glasses more. At some point they may become inconvenient or they may decide they do not really like wearing glasses. At that time it would be a good idea to consider contact lenses.” This message can be refreshed at each eye examination.

To maintain patient enthusiasm and engagement it is essential to package contact lenses in a manner that appeals to the teenage patient. Provide online materials, teenage-focussed promotions and in-practice displays that appeal to the teenage audience. It is for the whole practice team to ensure teenagers and their parents are aware of the advantages and disadvantages of all vision correction options, including contact lenses, enabling them to make the most appropriate choices.

Conclusion

Contact lenses improve the quality of life of all our spectacle wearers, whether they choose to be a full-time or a part-time wearer. Teenagers appreciate the practical benefits as much as older patients.

At a time when image and appearance are considered all-important, teenagers can be self-conscious about wearing spectacles. Contact lenses improve their self-esteem and provide them with the flexibility to transform their appearance, depending on their mood, style or personal preference. It must be made clear that they are not choosing between being a spectacle wearer or a contact lens wearer. You are giving them freedom to choose in which circumstances they wear spectacles and in which they wear contact lenses. They should always have an up-to-date pair of spectacles.

Compliance can be maximised by ensuring lenses are prescribed appropriate to their lifestyle. The ‘new day, new lens’ approach of daily disposables facilitates greater lens hygiene and matches the profile of a wearer with an active lifestyle. Daily disposables have been shown to have compliance ratings of around 81 per cent3.
Today’s teenagers are engaged and informed about the range of vision correction options available and 66 per cent are keen to wear contact lenses 4. Research challenges the myths that might prevent us from fitting teenagers. Contact lens wear offers quality of life benefits in terms of self esteem, athletic performance and flexibility.

By proactively discussing contact lenses with your teenage patient you will not only expand this under developed area of your practice but you will transform their lives.

Key Points
  • Studies show that young people can be successfully fitted with contact lenses in about the same time as an adult.
  • Contact lens wearing children feel better about their physical appearance, athletic competence and social acceptance than their spectacle wearing contemporaries.
  • Average age that people notice they need vision correction is 13 years.
  • Compliance can be maximised by ensuring lenses are prescribed appropriate to their lifestyle.
  • Be proactive by discussing contact lenses with your teenage patient, to expand this under-developed area of your practice, and transform lives.
Andrew Elder Smith serves on the Ciba Vision Professional Advisory Panel and is a Faculty Member of the Ciba Vision Academy for Eyecare Excellence. He owned a practice that won Contact Lens Practice of the Year 2008 in the Optician Awards. He sold the practice in 2008 and has set up a training consultancy Contact Solutions Consultants offering personalised training packages provided in locations convenient to individuals. Mr. Smith also supervises clinics in primary care, binocular vision and contact lenses at the University of Bradford and from July 2007 to January 2009 he served as President of the British Chapter of the American Academy of Optometry.This article was first published in Optometry Today (Jul 2009) under the heading ‘Do Teenagers Deserve Contact Lenses?’ and written by Andrew Elder Smith. It has been adapted, for reproduction in mivision, by Helen Gleave, Professional Affairs Manager for Ciba Vision, Australia and New Zealand for the Ciba Vision Academy For Eyecare Excellence and is reproduced with kind permission from the author.
References:
1. 
Walline JJ, Jones LA, Sinnott L, Chitkara M, Coffey B, Jackson JM, Manny RE, Rah MJ, Prinstein MJ, Randomized trial of the effect of contact lens wear on self-perception in children. Optom Vis Sci. 2009 mar; 86(3):222-32
2. 
Walline J, Gaume A, Jones LA, Rah MJ, Manny RE, Bernsten DA, Chitkaraa M, Kim A, Quinn N. Benefits of contact lens wear for children and teens. Eye & Contact Lens 33(6): 317-321, 2007
3. EU Contact Lens Wearers U&A, 2006.
4. EU Glasses Wearers U&A, 2006.
5. 
Walline J. Contact Lens In Paediatrics [CLIP] Study: Chair Time and Ocular Health. Optom Vis Sci 2007; 84(9): 896-902

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