• Contact Lenses For Teens

    Teenagers Need Lenses Too

    By John Dick ABO, FNAO

    Meeting Your Teen’s Needs

    Once you’ve made the determination as to whether your teen is mature enough to handle the responsibility of the care and maintenance of contact lenses, it’s time to look at the different lenses on the market and what’s available to meet certain eyecare needs. You should ask yourself a few questions: how active is my teen? Does my teen play sports? Would it be better for my teen to use daily disposable lenses or planned replacement contacts? Does my teen’s ocular history provide certain extenuating circumstances such as ocular allergies or uncomfortable contacts when previously fitted? Are there any activities which would preclude my teen from wearing contacts? Does my teen have a particularly difficult prescription? Whatever your concern there has never been a better time to be a contact lens wearer. Generally, your eyecare professional will take these matters into consideration when your teen undergoes their initial evaluation or successive evaluations. The doctor will determine what design and brand of contact will work best for your child.

    Working with Your Doctor

    However, as parents, being prepared to bring up certain concerns or questions with your eyecare professional when either fitting your teen or trying to address an ongoing problem will be advantageous to all parties concerned. An important thing to remember: when it comes to contact lens wear knowledge is power. The more information you give your eyecare professional and the better equipped you are to understand the differing modalities available to correct certain problems you and your eyecare provider will be able to arrive at a good decision for your teen’s vision and eye health. These will not only resulting in your teen seeing better, but also increasing the comfort experienced when wearing their lenses.

    Lens Types

    There are several different types of lenses on the market today to correct for several types of refractive errors such as astigmatism, hyperopia (farsightedness), myopia (nearsightedness), or chronically dry eyes and patients more prone to protein deposits and allergens. Of course, your eyecare professional will take into account your teen’s medical history, ocular history, special fitting considerations and modalities available to correct their vision.

    Benefits of Hydrogel Lenses

    Hydrogel lenses have been introduced in the last few years making contacts more comfortable than ever.  These lenses are hydrophilic (meaning water-loving). They typically possess materials embedded in the contact surface which act as a polar molecule thereby attracting water molecules. This polarity helps the contact to retain moisture making lenses more comfortable over the course of wear, staves off infections and bacterial colonization and assists the eye in removing debris from the surface of the cornea. Additionally, these lenses are typically highly viscous, meaning they possess an extremely slick surface. This is beneficial in that denatured proteins are not allowed to gain a foothold and build upon deposits which may settle on the lens surface. Protein deposits can grow into a major complication resulting in an irregular cornea and poor vision which is difficult to correct.

    Aspheric Lens Designs

    Aspheric lenses are designed to provide the patient with a wider field of view by decreasing the amount of curvature along the lens surface. Consider a flat screen TV and high definition broadcasting. Think about the curved shapes of older television models and the amount of distortion which may be viewed along the periphery of the screen. Images may appear to be somewhat distorted. People may seem a little taller and images not as highly defined. Over the course of time, we had learned to dismiss this until the advent of high definition television and the broadcasting of high definition programming showed us what we were missing. The same could be said of aspherically designed lenses.

    Applying the principles of asphericity to ophthalmic lenses and contact lenses has provided the patient with a great move forward in optical clarity. The power of a lens is based on its curvature. The radius of curvature is the term given to the curve or shape of these lenses. In order to produce an aspheric effect, these lenses minimize the distorted effect whether minifying (making images appear smaller) or magnifying (making appear larger) by maintaining the same curvature over a wider area. This in turn provides the patient with a lens which is less curved and less distorted along the peripheral edges. What results is less distortion along the peripheral edges (especially in higher powered prescriptions), a wider central zone with clarity and ultimately a more comfortable fit. This is why some contact lens manufacturers have seized on the concept of high definition television by touting these lenses are “like having HD TV for your eyes.” Since they’re not as curved the edges of the lenses don’t fit quite as tight. A less tightly fitting lens allows for greater comfort around the contact edge enhancing the experience of wear and providing comfort throughout the day.

    Toric Lenses

    Toric contacts are designed to correct the common refractive error of astigmatism. Astigmatism is probably the least understood refractive error among the general public. Most do not realize it is the most common refractive error among the general population; edging out hyperopia (far-sightedness) myopia (near-sightedness) and presbyopia (need for bifocals). It is not an easy concept to comprehend since it involves understanding how light is refracted through different mediums.

    The refractive medium of the cornea is responsible for nearly 1/3 of the refractive capability of the eye; the remaining 2/3 resides with the crystalline lens and its ability to flex. The cornea’s shape determines whether the patient is nearsighted (meaning light rays come to focus at a point in front of the retina), farsighted (behind the retina) and astigmatism (at two different points on the retina). Astigmatism arises as a result of the surface of cornea having an irregular shape. This shape resembles a football (elliptical) shape rather than a spherical shape such as a tennis ball. When light enters the cornea, this elliptical shape causes the light rays to split and focus at two different points on the retina rather than one as in the case of hyperopia or myopia.

    This refractive error is corrected with the addition of cylinder power to the contact lens. Spherical lenses are designed with powers being equal in all meridians. In fact, spherical contact lenses will rotate with each blink of the eye and still maintain the same level of visual acuity since the power is the same in any meridian. Not so, with astigmatic contact lenses. These lenses are corrected for both the nearsightedness/farsightedness of the patient in addition to the cylinder required for the amount of astigmatism correction. The contacts are corrected in two meridians at right angles to one another.

    Since this requires the contact to remain in a static position, the contact is weighted to prevent the lens from rotating. This weight is known as prism ballasting. One of the ways to determine whether a toric lens is a good fit for the patient is through timing its rotational recovery period. The rotational recovery period is the amount of time it takes for the lens to return to its original position if rotated by the eyecare professional at 45⁰. A good rotational recovery rate is considered anything less than 15 minutes. Once in its proper place the lens is correcting both myopia (nearsightedness) or hyperopia (farsightedness) and the astigmatism as it resides on the surface of the cornea and providing the highest level of visual acuity. Developments have occurred in the last few years in contact lens design and manufacture which places prism ballasting in more than one meridian adding extra security to where the contact is oriented and provide an even quicker rotational recovery period.

    Planned Replacement Lenses v. Daily Disposables

    The evolution of soft lenses involved using enzymatic cleaners to remove protein deposits, saline solutions for cleaning your lenses vigorously and was fraught with complications associated with bacteria and conjunctivitis. Eventually, soft lenses became main stream and were available in multiples. This was accompanied by a wearing regimen in which the patient was required to replace them at different intervals. This improved the overall quality and health of the patient’s eye since potential problems were prevented from developing further with the disposal of old contacts. Finally, manufacturers began producing daily disposable lenses. These lenses worked well for patients who were more prone to protein deposits, ocular allergies/bacteria, and corneal neovascularization (deprivation of oxygen). All of these problems are easily arrested using daily disposables since you simply cast away the lenses at the end of the day and begin each day anew.

    Eyecare professionals and parents need to consider the maturity of the teenager and whether they will faithfully observe cleaning their lenses, removing them nightly and observe hygienic standards when handling their contacts. Activities may also play a vital role. If your teen is active, convenience may become a factor. Devoting time to contact lens cleaning regimens versus using daily disposable lenses may very well settle the question of which contact you would prefer and will help prevent serious complications. The other advantage to daily disposables is their ability to give you crisp, clear vision daily. Unlike planned replacement lenses which may be worn for a month or longer, the quality of the material doesn’t have the time to degrade since it is disposed of at day’s end.

    Active teens are also more prone to getting debris in their eyes. For example, playing football, soccer, baseball, etc. will often kick up dirt and other particulates which may go into the eye and cause irritation by becoming trapped under the lens or the eyelid or disrupt the ability to wear their contacts. Of course, if the sensation of a foreign body exists, you should always stop contact lens wear and consult your doctor. Disposable lenses are great for preventing problems such as these because you simply replace them if you begin to have problems with the existing lenses. You can simply toss out the potential for any complications before they arise by grabbing a new pair.

    The Active Teen

    When your teen participates in activities such as playing video games, driving, playing sports, or just horsing around it’s always important to receive and interpret information quickly. This is made possible by having good vision. It has been estimated that nearly 7/8 of all our knowledge comes to us through our eyes. The ability to perceive information visually, understand and anticipate problems or actions which need to be taken will not only protect your teen from potentially harmful injuries, but may also heighten their ability to play. Glasses are great for wearing when engaged in low impact, sedentary activities, but not when engaged in high-impact sports. Contending with possible frame adjustment issues, simply absorbing rough activity knocking your glasses out of place, or difficulty perceiving other players in your periphery if you have a high powered prescription may all contribute to poor performance on the field or court. This is why wearing lenses with specialty tints for higher contrast sensitivity or aspheric contact lens designs will all work to increase the quality of vision allowing decisions to be made somewhat quicker than with glasses. This translates into better playing ability for your teen.

    Sports Contacts

    A few contact lens manufacturers also provide lenses specifically designed for playing sports. These lenses are tinted to enhance contrast sensitivity and cut glare; two factors which may contribute to poor play. The contrast sensitivity enhances the ability of the wearer to see better in lower lighting situations, enable them to readily identify movements of people and objects (such as balls), and allows for a quicker reaction time. Of course, glare is another major concern. Anytime a player is distracted by the glint of the sun the distraction may cause them to miss that all important play. Cutting the glare simply removes one of the obstacles which may hinder those more susceptible to being distracted allowing them to play at their best and exercising some control over the playing environment.

    Cosmetic Lenses

    Although it’s sometimes low down on the list of priorities for your eyecare professional, providing cosmetically enhanced lenses which change eye color may be something of a priority for your teen. When colored lenses first came on the market, those patients with darker pigmented irises were generally left out. Now cosmetically lenses are produced to obscure the darker irises by providing an opaque design which allows the patient to change eye color. It’s important to remember with opaque designs they may not allow the contact to breathe as well as conventional lenses. Of course, you should always follow the advice of your eyecare professional, but it’s important to remember to remove these lenses at night before going to bed to prevent a common contact lens complication known as corneal neovascularization.

    Caution When Wearing Color Contacts

    Corneal neovascularization occurs when the corneal surface is deprived of oxygen such as can occur when wearing lens for too long (especially opaquely colored ones). The eye attempts to correct this problem by growing new blood vessels which carry oxygen to the deprived areas; bringing with them much needed oxygen and nutrients. Complications occur if these vessels begin to intersect the visual axis; the pathway light travels on its way to the retina allowing the process of vision to occur. Removing your lenses before going to bed, or wearing lenses which are approved for continuous wear will mitigate this problem and prevent the complication from arising.

    Advances in Color Contact Technology

    The last few years have seen many advances in providing cosmetic lenses which have a natural appearance. Some lenses are designed to complement the vascular structure of the iris providing a more natural appearance when changing eye color than with opaque lenses. These are typically referred to as enhancing tints to underscore the relationship between using the natural appearance of the iris and the colorization provided by the lens. Many of these lenses use a varying number of tints in color and saturation to provide depth to the enhancement resulting in a more natural look. This is much the same way a painter brings depth to a painting by bringing certain elements to the foreground of their canvas. It has a blending effect which provides this appearance to the lens not seen in earlier color contact designs. It’s also important not to dismiss the psychological impact which results when teenagers can see well without wearing bulky glasses and changing their eye color to suit their taste. It is well known among eyecare professionals that some teens are provided a sense of confidence which comes from looking their best. This inevitably contributes to their overall social well-being and sense of worth and what parent doesn’t want a healthy, happy teen?


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