Abstract: Kids, contacts and dry eye

You know, I find the trend to fit younger and younger children with contacts very disturbing. We know from the literature that tear film degrades with age and is at its very best in childhood. Since their tear film is best able to support a lens... this means it's OK to give them lenses and thus extend the years they're going to expose their eyes to this risk?

I myself started wearing contacts in 6th grade, which was unusual back in those days. There was a reason, though, and I certainly didn't seek contacts on my own. I was a very high myope and always had some trouble seeing well with glasses. They tried to put hard lenses on me and it didn't work out. A year or so later I started wearing soft lenses. Over time more and more peers joined me. I kind of think that the younger you start wearing contacts, the more potential for getting really well established in poor eyecare habits. To this day I shudder to think of how I cared for (or didn't) those contacts. During my mid teens I think I did alright, but during late teens and early twenties, I suppose I succumbed to the invincible attitude typical of those ages, not to mention the starving student's attitude to paying for eyecare.

If I could do it all over again, I really think I would have stuck with glasses. But it would have been much easier if small frames had been fashionable when I was young. They weren't, and large frames looked ridiculous in my prescription.

Dry eye in pediatric contact lens wearers.
Eye Contact Lens. 2010 Nov;36(6):352-5.
Greiner KL, Walline JJ.
Davis Duehr Dean Eye Care, Madison, WI, USA.

OBJECTIVE: To determine whether children who wear contact lenses truly have fewer dry eye complaints than adults do.

METHODS: Ninety-four pediatric contact lens wearers, aged 8 to 14 years, were recruited and given the Contact Lens Dry Eye Questionnaire (CLDEQ) short form. The survey is designed to diagnose dry eye syndrome by obtaining information on the frequency of dryness and light sensitivity and their corresponding intensity levels within the first 2 hr of putting in the lenses, in the middle of the day, and at the end of the day. The responses were scored by multiplying the frequency by the average intensity and a constant. A composite score was calculated by subtracting the photophobia score from the dryness score, and the results were compared with those of adult samples from the literature. The questionnaire also asked whether the subject believed he or she had dry eyes while wearing contact lenses. Subjects who believed that they had dry eyes and exhibited a CLDEQ composite score >0.03 were diagnosed with dry eye. Subjects who were unsure if they had dry eyes or said they did not have dry eyes but scored >1.29 were also diagnosed with dry eye.

RESULTS: The average (±SD) age of the sample was 11.7 ± 1.5 years, 56.4% were female, 59.6% were white, and 19.1% were black. The mean (±SD) CLDEQ composite score was 0.25 ± 0.50 (range = -1.20 to 1.45). In the literature, the adult mean (±SD) CLDEQ composite score was 1.02 ± 0.80 (range = -0.74 to 4.50). Of the 94 surveys collected, 4.3% of children were categorized as having dry eye compared with 56.2% of the adults who completed the CLDEQ survey in the adult study.

CONCLUSIONS: Pediatric contact lens wearers have fewer complaints about dry eyes than do adult contact lens wearers, which may be because of improved tear film, differences in reporting of symptoms, or modality of contact lens wear.