Kids and Contacts: How Old is Too Young?

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1 Kids and Contacts: How Old is Too Young? Generation Z Born: Children Ages 6 10 yrs. Preteen Ages yrs. Dr. Kris Kerestan Garbig krisgarbig@fuse.net Teen Ages yrs. Generation Z Children & Contact Lenses AOA and Vistakon Study Characteristics: Ø Technology since BIRTH!! Ø Extreme involvement in sports and other activities Ø Always on Social Media Purpose of the survey was to gauge current trends in prescribing contact lenses to children ranging in age from 8 to 17, and to understand factors that influence an optometrist s decision to fit a child in contact lenses. 576 American O.D.s participated Children & Contact Lenses AOA and Vistakon Study AGE FACTORS in prescribing 97% of the O.D.s surveyed said they fit CLs on patients younger than 18 years 41% of all the CL patients in their practices are actually kids under the age of 17 years Of the 41% of Kids fit in CL: 19% were between yrs 13% were between yrs 7% were between yrs 2% were between 8-9 yrs < 1% were 8 or younger 1

2 Children up to 17 yrs. account for 41% of all Contact Lens fits What AGES are Soft Contacts FIRST introduced as Primary mode of Visual Correction? < 8 yrs Age 8-9 Age Age Age % of Docs years of age 50% of Docs years of age 20% of Docs years of age What AGE is Appropriate to Introduce a child to Soft Contact Lenses for the FIRST time? Below 8 yrs. 12% Age 8-9 yrs. 12% Age yrs. 51% Age yrs. 23% Ages yrs. 3% Why are we fitting Kids in CL at Younger Ages?? 33% say due to DAILY DISPOSABLES: Why Daily Disposables? 1. Most Healthy option 2. Minimal Care/ No CL Soln s 3. Extremely Flexible Why Daily Disposables?? Healthiest option: New, Fresh, Clean CL Q day No chance for buildup of protein or CL debris Best choice for Allergy patients No protein buildup + Better wetting Why Daily Disposables?? Minimal Care/No Solutions: Saves Time and Saves Money ($$) Eliminates Soln. Related Red Eyes Eliminates Soln. Related Allergies 2

3 Why Daily Disposables?? Extremely Flexible: Sports Dance Gymnastics Drama Swimming Other Activities What Daily Disposables?? Aua Comfort Plus- sphere, toric and multi. Acuvue Moist- sphere, toric, multi (UV), define 1 Day Oasys-toric Biotrue- UV, spher aberration control, high H2O Dailies Total 1- Only water gradient CL Clariti 1 day Proclear- sphere Soft Lens- sphere Daily Disposables Why are we fitting Kids in CL at Younger Ages?? 44%+ of the U.S. market > 90% of Asian market > 80% of European market 23% say due to IMPROVED CL MATERIALS: (Silicone Hydrogel) } Extremely comfortable } Increased O2 to cornea } Ease of handling } UV protection (Important to 85% parents) Which CL s have UV Protection?? Acuvue Oasys 1 Day Moist 1-Day Oasys True Eye Biotrue Why are we fitting Kids in CL at younger ages?? 19% say due to Parent or Child Reuest: - More awareness of benefit of CL for school and sports activities - Friends wearing CL 3

4 Why are we fitting Kids in CL at younger ages?? 10% due to Current Research: 10% due to Parent Awareness: Articles in Magazines: Woman s Day Ladies Home Journal U.S. News and World Report Why are we fitting Kids in CL at younger ages?? 10% say participation in sports and other activities: Often start with PT wear Info. on the Internet Most Important Fitting Factors Considered Interest and Motivation of the Child ( Most important factor 96% of O.D.s) Maturity Level (93%) Personal Hygiene (89%) Ability to take care of contact lenses by him/herself (89%) Parental help and support Least Important Fitting Factors Considered 74% of optometrists surveyed say that gender does NOT influence their decision to fit a child in contact lenses 26% say they are more likely to fit younger children when they are girls. 68% -Annualized cost of contact lenses Most Important CL Properties to Consider Quality of Life Study Ease of Handling Oxygen Permeability Comfort Visual Acuity Freuency of Replacement UV protection Total of 484 myopic children aged 8-11 years of age All children previously wore glasses 4

5 Quality of Life Study Quality of Life Study 50% of children continued in Glasses 50% of children fit in CL s 93 % chose Daily Disposables 7 % chose 2 Week Disposables After 3 yrs. their Vision-Related Quality of Life was assessed using an in-depth profile uestionnaire of 26 uestions ( Strongly disagree to Strongly agree) Increase Q of Life of 14.2 units in CL wearers Increase Q of Life of 2.1 units in Glasses wearers Quality of Life Study Quality of Life Study Conclusion Improved Self Esteem in Non Vision-related areas: Athletic Performance Appearance Peer Perception Freedom of movement Excellent peripheral vision Less distortion than glasses Clearer vision allows for deeper participation and understanding of materials in the classroom Quality of Life Study Practical ways to introduce CL to Kids for the first time Fitting Criteria used the 3 Ms 1. Maturity 2. Motivation 3. Mom Office brochures to stimulate interest and conversation about CL s Keep trials in the exam rooms as a visual reminder for you and the parent 5

6 Practical ways to introduce CL to Kids for the first time Use conversation starters... Have you ever thought about wearing contacts? Many people like wearing contacts for activities like sports, would you like to try them today? Practical ways to introduce CL to Kids for the first time Optometric Staff must show patience and care during the initial fit and I/R Send kids home with wear/care instructions BOTH Parent AND the Child Practical ways to introduce CL to Kids for the first time On-line resources from CL manufacturers Give the kids a way to communicate with the office , business card, cell # that they can text Elementary Age Challenges Short Attention Spans Keep Simple Small Palpebral Fissures Small diameter CL Developing Dexterity - Train parents I/R * Make sure an extra care kit is given for school* Preteen Challenges Challenging attention spans and gets bored easily Busy sports and school schedules Increasing life responsibilities and CL care Daily Disposables Succeeding with Kids and Contact Lenses KISS principle: - Keep - It - Simple - Succeed 6

7 Important Care Concerns CLIP Study CL in Pediatrics Study Always encourage extra Single use CLs or Extra Care Kits for Locker, Backpacks, Sports Bags Compliance Contract Signed by the CL wearer in which they take FULL responsibility for proper wear and care Compared CL wear in Children vs. Teens 84 children between 8-12 yrs. 85 teens between yrs. Protocol for fit, I/R training, FU 1 week, 1 month and 3 month CLIP Study CL in Pediatrics Study CLIP Study CL in Pediatrics Study Three variables were measured: Eye Health Ease of Fit Quality of Life Issues EYE HEALTH Eual adaptation between Child and Teen No serious adverse effects or eye health issues CLIP Study CL in Pediatrics Study EASE of FIT Essentially the same By 3 months 83% of the children vs. 89% of teens found it easy to clean/care for CL By 3 months little if any parental assistance was needed CLIP Study CL in Pediatrics Study QUALITY of LIFE improved in ALL areas Activities Satisfaction Appearance Peer Perceptions Overall Vision Far Vision 7

8 Safety Risks Lower risk of safety concerns in younger children (8-11 years) compared to teens Less microbial keratitis and infiltrative corneal events in younger children due to lower rate of noncompliant behavior and greater parental supervision Medical use of CL s in Children Myopia Control Aphakia Amblyopia Myopia Control with RGPs Progressive Myopia can result in a higher incidence of complications Retinal tears and detachments Glaucoma Cataracts Reduced uality of life Ortho-Keratology (Ortho K) Corneal Refractive Therapy (CRT) Overnight wear allowing for corneal reshaping Inhibits the growth of the eye's axial length, which determines the degree of myopia. Studies show capability to slow down eye growth by up to 45% compared to soft lenses and glasses Ortho-Keratology (Ortho K) Ortho-Keratology (Ortho K) Best Candidates 8 to 12 year olds with progressive myopia Low to mild nearsightedness (-4 diopters or less) 8

9 Soft Multifocals Study (OSU) Two-year study of children aged 8 11 years old with near-sightedness between -1 to -6 D and less than 1 D cylinder Compared SV to Multifocal with Add (NOT Low Add) Soft Multifocal Results 29% decrease in axial length 50% decreasedprogression of Myopia Creates a ring of increased power in the peripheral retina which the eye interprets as a "stop signal" for further growth. Also Relaxes focus and the reading effort Future of Soft Multifocals Future of Soft Multifocals MiSight- Cooper Vision Hong Kong on a trial basis, reported to be a daily disposable made of the ProClear material Reduced myopic progression by 37% over 20 months Alcon Vision is testing an anti-myopia siliconehydrogel contact lens that is reported to slow myopic progression by 34% over one year and 49% if one parent was myopic. Contact Lenses in Aphakia Anisometropia/Amblyopia After removal of Congenital Cataracts Silsoft lens (B+L) It is an extremely soft, extended wear lens made from 100 percent silicone polymer with the best oxygen permeability. Available from +7 D to +32 D Anisometropia Minimize Aniseikonia-image size differences Prevent the Unbalanced Lens appearance Amblyopia Occlusion therapy after traditional patching or Atropine fail 9

10 Thank You for your ATTENTION!! It has been a pleasure being here with you today Any Questions??? Dr. Kris Kerestan Garbig krisgarbig@fuse.net 10