Your children are starting back to school shortly and they have books, pencils, and backpacks, but do they have all they need? A child’s visual system is responsible for eighty percent of what they learn, and therefore, a visual system that is not functioning properly, will significantly interfere with their normal learning process.

I am always asked “How old should my child be for their first comprehensive eye exam?” The American Optometric Association guidelines recommend a first exam to evaluate vision and health, be done at age six months. Assuming no problems are found at that examination, a child should be re-examined at three years of age, and once again just before starting school. If the child is at risk or problems are seen then the examination schedule is more frequent.

Almost always when I tell parents this examination schedule, the question I am then asked is “but my child certainly cannot read letters yet - how can you examine them?” Well, you got me! The secret is out of the bag now! We eye doctors don’t really need you to read the letters to perform our examination. In fact, we can determine your prescription without any response from you at all - and we do it all the time. The only reason we ask you to read the letters is because that gives us some additional information that can guide our decision making process.

It is sometimes difficult for parents to identify vision problems in their child since children are very adaptable. First, no child will ever complain that they can’t see. They don’t know what clear vision is supposed to look like and so they do the best they can with what they see. They don’t know that everybody isn’t seeing the same way that they are seeing. Second, if one eye doesn’t see very well but the other one does, they can appear on the surface to be functioning normally. Third, children typically have their own agenda. What this means is that they may want glasses because one of their friends just got glasses or they may not want glasses even if they can’t see well for fear of being made fun of by their peers.

Can kids really wear contact lenses? I don't think that my child is old enough or responsible enough to wear contact lenses. If my child can't even keep their room clean, how are they going to be able to take appropriate care of contact lenses? What is the proper age to consider contact lenses for children? Are these some of the concerns that you may have in correcting your child's vision with contact lenses?

You are not alone. I find that these are the most commonly asked questions by parents after I suggest contact lenses for their children. Let's answer these questions one at a time.

How young is too young? Actually, there is no age that is too young for contact lenses. There are many instances requiring that even infants be fit with contact lenses. In my personal experience, children between the ages of four and six years of age are generally mature enough to be self-sufficient in caring for their contact lenses. These children do very well and really take excellent care of their lenses. They seem to understand that wearing contact lenses is a privilege and that they have been given a very "adult" responsibility.

So what does keeping a room clean have to do with wearing contact lenses? Actually, absolutely nothing. Keeping a room clean may be beneficial but usually not for the child. The untidy room could represent anything from rebellion to laziness but rarely will indicate how well a child will do with contact lenses. The benefits of contact lenses to children in addition to providing excellent vision and freedom in activity, are increased self-esteem and self-confidence. Their whole image is enhanced. On many occasions I have seen shy, reserved spectacle wearing children come out of their shell after beginning to wear contact lenses. Children have a strong desire both to "fit in" as well as feel special. Contact lenses address these issues very well because the child's vision correction is "invisible" to their peers and lenses are truly a special privilege.

In addition to what has already been mentioned there is also a therapeutic advantage to gas permeable contacts and nearsightedness. There has been study data to show that wearing gas permeable contact lenses are three times more effective at slowing the progression of nearsightedness than spectacles. With the nearsighted prescription increasing there is an increase in the dependency on the correction being worn. Slowing down or stabilizing the advancing prescription can have the added benefit of allowing the continued function of certain activities without correction as well as avoiding the helpless feeling very nearsighted people have when they are not wearing their prescription.

Do you remember as a child, every year you would notice that your vision was not as good as before since the lights had haloes and you would have to squint to see things far away? Every year you received the sad news that you needed a stronger prescription and that your glasses were going to be even thicker than before. You asked if it was ever going to stop getting worse or would it just get so bad that you eventually would be blind. The continued worsening of distance vision comes from increasing myopia (near-sightedness) and is referred to as 'Progressive Myopia' or 'Myopic Creep.'

As you may remember, the more near-sighted you became the more difficult it became to do even some of the simplest things without wearing your prescription. Watching television, being able to identify who the person is that is coming toward you, or just making your way on the beach back to the people you came with after going for a swim. Of course, operating your car is impossible without your prescription. When the prescription reaches a certain point, even walking around the relatively safe environment of your house without your prescription becomes dangerous. The dependency on the prescription increases dramatically and with this comes the feeling of being 'handicapped' or helpless when not wearing the correction.

Are you seeing history repeat itself through your children? Are their glasses already being worn full-time and the loss of their freedom from a prescription been realized? The question I am always asked by parents is if there is anything that can be done to slow down or stop myopic creep. This has been and continues to be investigated thoroughly with various strategies and the method that has been shown to be most effective is having the person wear rigid oxygen permeable contact lenses.