Tweens & Contact Lenses – Made for each other!

By Shirley Ha, BSc. (Hons), O.D.

makingcontactWho are tweens? According to Wikipedia, they are youths, usually between the ages of 8 and 12. These young people go through a transitional phase of self-awareness and discovery, peer pressure and social acceptance as they develop their independence and interact with others. At that stage, adding eyeglasses with their associated social stigma can be an overwhelming experience. Alternatively, adjunct contact lenses can provide tweens with additional benefits beyond simple vision correction for refractive errors.

A literature overview by the Faculty of Social and Behavioral Sciences at the University of Amsterdam showed that wearing eyeglasses negatively impacted how children felt about their physical appearance because of negative stereotyping by peers.[i] In a study of 585 tweens and teens, eyeglasses were also perceived as socially unacceptable, while contact lenses were the preferred ‘eye correction choice’ for school, sports activities and hanging out with friends.[ii]

When should practitioners start introducing contact lenses to tweens? In the Children & Contact Lenses study conducted by the American Optometric Association, more than half (51 per cent) of 576 optometrists surveyed felt that 10 to 12 years of age was appropriate, while 12 per cent felt that ages eight to nine were suitable.[iii]

Among tweens, emotional and social behaviour varies, so the question of when they should start wearing contact lenses is often not a matter of age. Rather, factors such as interest, motivation, hygiene, maturity and sense of responsibility in adhering to the care and wearing schedule will determine a tween’s suitability and probability of success.

The three-year multi-site Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) Study from the Ohio State University College of Optometry revealed that myopic contact lens-wearing tweens felt significantly better about their physical appearance, social acceptance and athletic abilities than did tweens who wore eyeglasses. They also felt more confident about their academic performance if they initially disliked their eyeglasses.[iv]  A follow-up study concluded that tweens over the age of 10 who played sports, those who were motivated to wear contacts, and those who disliked wearing eyeglasses were the best candidates for contact lens wear.[v]

But can tweens handle contact lens care and wear once they pass the initial screening process? Several studies have supported the belief that tweens as young as eight are able to insert, remove and independently care for and wear contact lenses successfully.[vi],[vii] Similarly, the Contact Lenses In Pediatrics (CLIP) study of 84 tweens and 85 teens (13 to 17) showed that tweens were as compliant with contact lens care and wear instructions as teens.[viii]

There is also no evidence of increased eye health risk or harm for tweens wearing contact lenses. In the Contact Lens Assessment in Youth (CLAY) Study of 3,549 soft contact lens wearers, 8- to 15-year-olds had significantly fewer corneal infiltrative and inflammatory events (CIEs) than 15- to 25-years-olds.[ix] Another online survey showed that after 10 years of contact lens wear, 86 wearers fitted with contact lenses at age 12 or younger had similarly few adverse events, were as compliant, comfortable and successful as the 89 wearers fitted with contact lenses as teenagers.[x]

Tweens and teens have similar corneal anatomy and physiology.  They do not take more practice chair time to fit contact lenses and are shown to be as easy to fit as teens.

The trend to fit tweens with contact lenses is shifting. The advances in contact lens designs and materials are allowing eyecare practitioners to fit more children and tweens with contact lenses, especially daily disposables. Single use lenses are healthy, safe, simple, easy to handle and comfortable, and should be the first-time contact lens choice for tweens. 2,6 

Tweens are continually figuring out their identities and how they fit in with and contribute to society.  Even with today’s vast array of colourful and trendy frames, tweens welcome the prospect of contact lenses when given the opportunity. Although tweens make up a small percentage of your patient population, practitioners should ask about their interest in wearing contact lenses and never limit the choices available to them. Offer every tween and parent the option of selecting contact lenses as an alternative to eyeglasses. With parental approval and support, the social benefits, along with the known visual benefits and safety of contact lenses are undeniable.

Build on the excitement of that first fit and have tweens spread their enthusiasm to friends and family members. And don’t forget to prescribe appropriate sunglasses and eye protection for sports, too. Finally, what’s not to like about the revenue opportunities that happy parents and tweens offer you? They make for a winning combination.

[i] JELLESMA, F.C. “Do glasses change children’s perceptions? Effects of eyeglasses on peer- and self-perception”, European Journal of Developmental Psychology, July 2012, Volume 0, Issue 0, pp 1-12.

[ii] SILBERT, J.A. “Fitting Tweens and Teens with Daily Disposables”, Contact Lens Spectrum, April 2009.

[iii] Children & Contact Lenses: Doctors’ Attitudes & Practices in Fitting Children in Contacts, AOA Executive Summary, October 2010.

[iv] WALLINE, J.J., JONES, L.A., SINNOTT, L., CHITKARA, M., COFFEY, B., JACKSON, J.M., MANNY, R.E., RAH, M.J., PRINSTEIN, M.J., the ACHIEVE Study Group. “Randomized trial of the effect of contact lens wear on self-perception in children”, Optometry and Vision Science, March 2009, Volume 86, Issue 3, pp 222-32.

[v] RAH, M.J., WALLINE, J.J., JONES-JORDAN, L.A., SINNOTT, L.T., JACKSON, J.M., MANNY, R.E., COFFEY, B., LYONS, S.; the ACHIEVE Study Group.  “Vision Specific Quality of Life of Pediatric Contact Lens Wearers”, Optometry and Vision Science, August 2010, Volume 87, Issue 8, pp 560-6.

[vi] WALLINE, J.J., LONG, S., ZADNIK, K. “Daily Disposable Contact Lens Wear in Myopic Children”, Optometry and Vision Science, April 2004, Volume 81, Issue 4, pp 255-9.

[vii] WALLINE, J.J., GAUME, A., JONES, L.A., RAH, M.J., MANNY, R.E., BERNTSEN, D.A., CHITKARA, M., KIM, A., QUINN, N. “Benefits of Contact Lens Wear for Children and Teens”, Eye Contact Lens, November 2007, Volume 33, Issue 6, Part 1 of 2, pp 317-21.

[viii] WALLINE, J.J., JONES, L.A., RAH, M.J., MANNY, R.E., BERNTSEN, D.A., CHITKARA, M., GAUME, A., KIM, A., QUINN, N., and THE CLIP STUDY GROUP. “Contact Lenses in Pediatrics (CLIP) Study: Chair Time and Ocular Health”, Optometry and Vision Science, September 2007, Volume 84, pp 896-902

[ix] CHALMERS, R.L., WAGNER, H., MITCHELL, L., LAM, D.Y., KINOSHITA, B.T., JANSEN, M.E., RICHDALE, K., SORBARA, L., MCMAHON, T.T.  “Age and Other Risk Factors for Corneal Infiltrative and Inflammatory Events in Young Soft Contact Lens Wearers from the Contact Lens Assessment in Youth (CLAY) Study”, Investigative Ophthalmology & Vision Science, August 2011, Volume 52, no. 9, pp 6690-6.

[x] WALLINE, J.J., EMCH, A.J., LAUL, A., REUTER, K., NICHOLS, J.J. Comparison of success in contact lens wearers fitted as children vs teenagers, ARVO poster May 2011.