Dec 23 2009
Infants as young as one-month-old are prescribed contact lenses at pediatric eye surgery centers so their visual system will develop correctly. Infants may be fitted for contacts if they have had cataract surgery, need extremely high-strength prescription glasses, or have very different prescriptions for the two eyes.
According to Dr. Natalia Uribe, who directs the Contact Lens Program in The Vision Center at Childrens Hospital Los Angeles, “The brain’s visual system is not fully mature until about age eight. It is critical that infants and very young children with eye problems have their sight corrected so the visual pathway develops properly. Otherwise it may not be possible for them to enjoy normal vision as an adult.”
Dr. Uribe, an optometrist, said her clinic is growing and will treat more than 700 young patients this year, making it one of the largest centers in the nation. She said more infants are being diagnosed with major eye problems due to better screening and to the higher rate of survival among extremely preterm infants.
Premature infants are at risk for retinopathy of prematurity (ROP), a disease affecting the blood vessels feeding the retina and for other eye problems. Medical studies have shown that approximately 20 percent of all premature babies will develop some form of strabismus (crossed eyes), amblyopia (lazy eye) or serious refractive error (require glasses) by the time they are 3 years of age.
According to Dr. Uribe, “Many of the children I see have a medical condition that affects only one eye. Wearing glasses with one thick lens and one clear lens will not work on very young children. A properly fitted contact lens can produce near-normal vision -- the images are the same size, clear and focused, and input equally from both eyes--spurring proper brain development.”
For example, if an infant is born with a congenital cataract, the lens inside the eye, which is used for focusing, is cloudy. Vision development in that eye is blocked, leading to amblyopia as the child grows.
When a cataract is surgically removed in an adult, it is usually replaced with a lens implant. Lens implant surgery does not work for very young children because their eyes are growing so rapidly. Contact lenses are the preferred choice because they can be refitted frequently and they provide more natural vision than lop-sided cataract glasses.
Contact lenses for young children run from $90 to $300 per lens depending on the prescription. Because of the huge changes that occur in the eye during a baby’s first year of life, children may require up to six different prescriptions. The lenses are considered medically necessary (vs. cosmetic use), so insurance generally covers at least some of the costs associated with them.
Dr. Uribe reports that parents are generally scared to insert the lenses at first, but quickly develop ways of coping. As the child grows, he/she often becomes responsible for his/her own lenses at age seven or eight.
“Although we often think of contact lenses as appropriate cosmetically for teenagers, they can also be a good alternative for school-age children who wear glasses and want to participate in sports or are subject to teasing,” said Dr. Uribe.