The Use of
Therapeutic Contact Lenses
in Pediatric Patients
with Low Vision
Kelly E. Lusk, Ph.D.
Terry Schwartz, M.D.
Cincinnati Children’s Vision Rehabilitation Program
(CCVRP)
Points of contact
- An overview of therapeutic contact lenses?
- Literature review
- Contact lens use in children
- Therapeutic CL use in persons with low vision
- Therapeutic CL use in children with low vision
- Discussion
- Contact lenses with other low vision rehab options
- Future directions with the pediatric population
What is low vision?
• A person with low vision is “a person who has
measurable vision but has difficulty
accomplishing or cannot accomplish visual tasks,
even with prescribed corrective lenses, but can
enhance his or her ability to accomplish these
tasks with the use of compensatory visual
strategies, low vision devices, and environmental
modifications” (Corn & Lusk, 2010, p. 4-5).
• Low vision devices include optical, non-optical,
and electronic devices.
What are therapeutic contact lenses?
• A therapeutic CL is a lens that can be
prescribed to some patients with low vision
to further enhance visual functioning
Characteristics of Therapeutic Contact Lenses
• Can be hard or soft lenses
• May have a prescription for a refractive error
• May be clear, tinted, or opaque
Why are therapeutic CLs prescribed?
•
•
•
•
•
•
Light control
Cosmetic purposes
Pathologies (e.g., keratoconus)
Patients with high refractive error
As a part of a more complex lens prescription
Therapeutic contact lenses in conjunction with
other low vision rehabilitation options, such as
near and distance magnification.
Literature Review and Discussion
• Contact lens use in children
• Therapeutic CL use in persons with low vision
• Therapeutic CL use in children with low vision
• Relative lack of studies specifically on pediatric
population
• Relative lack of studies looking at additional low vision
rehab options/interdisciplinary models
Why are these important?
Where do we go from here?
Future Directions
• Large scale study (or studies) of children with low vision
– Light-controlling contact lenses with and possibly without further
vision rehabilitation options
• Albinism, Achromatopsia, Aniridia, Cone Dystrophies
– Age to prescribe (evaluations and follow-up)
– Improvement in functional outcomes (visual performance, comfort,
social acceptance, ECC areas, etc.)
– Longitudinal data to support findings, continued use
References
Efron, N., Morgan, P. B., Woods, C. A., & The International
Contact Lens Prescribing Survey Consortium. (2011).
Survey of contact lens prescribing to infants, children, and
teenagers. Optometry and Vision Science, 88, 461-468.
Jones, L. A., Walline, J. J., Gaume, A., Rah, M. J., Manny, R.
E., Berntsen, D. A., Chitkara, M., Kim, A., & Quinn, N.
(2009). Contact Lens and Anterior Eye, 32, 157-163.
Kruijt, B., Franssen, L., Prick, L., van Vliet, J., & van den
Berg, T. (2011). Ocular straylight in albinism. Optometry
and Vision Science, 88, E585-E592.
References, continued
Park, W. L., & Sunness, J. S. (2004). Red contact lenses for
alleviation of photophobia in patients with cone disorders.
American Journal of Ophthalmology, 137, 774-775.
Rajak, S. N., Currie, A. D. M., Dubois, V. J. P., Morris, M.,
& Vickers, S. (2006). Tinted contact lenses as an
alternative management for photophobia in stationary cone
dystrophies in children. Journal of AAPOS, 10, 336-339.
Stevenson, G., & Gardner, L. (2010). Progressive cone
dystrophy, nystagmus, and contact lenses. Contact Lens
and Anterior Eye, 33, 228-230.
References, continued
Walline, J. J., Jones, L. A., Chitkara, M., Coffey, B., Jackson,
J. M., Manny, R. E., Rah, M. J., Prinstein, M. J., Zadnik,
K., & The ACHIEVE Study Group. (2006). The adolescent
and child health initiative to encourage vision
empowerment (ACHIEVE) study design and baseline data.
Optometry and Vision Science, 83, 37-45.
Walline, J. J., Jones, L. A., Rah, M. J., Manny, R. E.,
Berntsen, D. A., Chitkara, M., Gaume, A., Kim, A., Quinn,
N., & The CLIP Study Group. (2007). Contact lenses in
pediatrics (CLIP) study: Chair time and ocular health.
Optometry and Vision Science, 84, 896-902.
References, continued
Walline, J. J., Long, S., & Zadnik, K. (2004). Daily
disposable contact lens wear in myopic children.
Optometry and Vision Science, 81, 254-258.
Questions?
Thank you!
[email protected]