Contact lenses vs. spectacles. Which is best for my child?

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Refractive errors such as myopia (near sightedness), hyperopia (farsightedness), and astigmatism can be corrected by various methods: spectacles, contact lenses, and refractive surgery.   Your child’s age, level of responsibility, visual condition, and visual demands all play a role in determining the most suitable option.   

Very young children, those with very high refractive errors, or children with significant difference in refractive error between their eyes may actually do better visually with contact lenses than spectacles   Obviously, the younger the child, the more involved the parents need to be to maintain appropriate replacement and care and cleaning of the contact lenses. Contact lenses can be customized for the smaller eyes of infants if required, and newer, more oxygen permeable options now exist for the added convenience of increased wear time and reduced removal and insertion frequency.   

Among the reasons for large refractive errors can be genetics, or the removal of congenital cataract in one or both eyes.  If a large difference exists between the eyes’ focusing abilities, corrective lenses result in the brain receiving different sized images from each eye which can lead to difficulty with comfortable fusion of the images.   Contact lenses minimize the image size difference more effectively than spectacles which can make for more comfortable vision. Additionally, very high refractive errors can result in thicker, heavier lenses leading to heavier spectacles, which on the small facial structure of an infant or toddler can be uncomfortable and difficult to keep on.  There is no “magic” age for contact wear; any age from infants to teens can be successfully fit with contacts.  

There are also many visual situations where spectacles are the better visual corrective option.  For example, spectacle wear allows for quick and easy removal of the lenses in those children who wear corrective lenses just for near work. Also, children with strabismus (a turned eye), in some cases, have improved ocular alignment with the use of prism in spectacles. Additionally, children who suffer from ocular allergies often find spectacles more comfortable than contact lenses, and certain refractive conditions such as extreme amounts of astigmatism have more limited success with achieving clear vision with contact lenses.  There are also individuals that simply prefer to not insert contact lenses, or love the fashion aspect that varying frames provide.

For older children and teens, and those involved in sports or theatre often the option of both contact lenses and spectacles makes the most sense to meet their varying visual demands.   

In terms of refractive surgery, this is a third and excellent option for certain refractive conditions but not one that is utilized in children.   Individuals must be a minimum of 19 years of age and have reached stability in their refractive error before this can be successfully used as an alternative to correction by spectacles or contact lenses.  

Ultimately, the choice between spectacles and contact lens, or the use of both, depends on both the visual condition and visual demands of the individual.

Written by Cowichan

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