Contact Lenses for Infant Aphakia
What is Aphakia?
Children born with cataracts often need surgery in the first few weeks of life to remove the opacity and allow light to properly reach the retina. Often, surgeons prefer not to implant an intraocular lens (IOL) during the cataract removal until later in life due to the increased risk of congenital glaucoma and other risks of surgery in small children.
Why are contact lenses needed?
Without a natural crystalline lens, the eye is left with roughly 20-30 diopters of hyperopia (far sightedness)
Without clear vision, the eye will fail to develop the connections to the brain properly, resulting in amblyopia or “lazy eye” causing lifelong vision impairment.
Infant aphakia glasses are too heavy and thick for a child to wear. Many children will not tolerate wearing glasses, so adherence to this therapy can be challenging.
Contact Lens options for Aphakia
The type of contact lens recommended for your child will depend on your child’s unique eye shape and size. Often, the type of contact lens is chosen after a full conversation about what to expect with the child’s parents. Some parents decide on what lens to try based on the ease of insertion and removal in clinic.
Soft Contact Lenses
These custom-made contact lenses are made of high oxygen-permeable materials to ensure healthy contact lens wear is achieved during naps. These lenses are intended to be worn for 3 months before disposal.
Rigid Gas Permeable Contact Lenses
These lenses are made of a plastic that maintains its shape at all times. They are extremely customizable and can be made to any parameter requested. These lenses can be worn for up to a year, however, due to the continued growth of the cornea, usually need to be replaced with an adjusted lens every 3 months.
Lens Loss
As your child begins to crawl, walk, run and jump, there is potential for the contact lens to be accidently dislodged from the eye and lost. We strongly encourage parents to have back-up lenses.
What can I expect?
We take special pride in our management of children in contacts, ensuring we have as much appointment time as required. Your first visit may take up to 1 hour, and dilating drops may be necessary to ensure accuracy of measurements.
Once your child’s custom lens has been ordered, a delivery and training appointment will be scheduled 3 weeks later. This appointment is 1 hour in length to ensure you have the time necessary to learn how to insert, remove, and care for the lenses.
If your child is aphakic in only one eye, often we will recommend patching the good eye to encourage the neurosensory development of the aphakic eye.
During the first 2 years of life the eyes grow rapidly, so follow-up appointments will be scheduled every 1-3 months.
Between the ages of 3-5, follow-ups are recommended every 3-6 months.
We understand this can be a challenging time for parents and caregivers, so we are happy to offer unlimited follow-up visits as well as after-hours contact by phone.
Investment
We charge an annual contact lens fit & design fee, which includes all visits for 12 months for $450. This fee is non-refundable. Contact lens material prices are in addition to this fee and can range from $1,100-1,560/eye per year.
What about Glasses?
After your child’s contact lenses are finalized, glasses are often still recommended for protection purposes. They will also discourage your child from rubbing their eyes. As your child nears school-age, bifocals will also be necessary to help your child focus up close as well as far away.
further supports
Support groups are great for information and to connect with other parents, but these groups can sometimes be overwhelming! Do not be afraid to ask us about anything you hear online as it may not always apply to your child.
Aphakic Kids Facebook Group
www.facebook.com/groups/139232330344/
Children with congenital cataracts
https://groups/119006164779279/
Congenital cataracts facebook
www.facebook.com/groups/436422123133209/
Little Four Eyes
www.littlefoureyes.com
www.facebook.com/groups/littlefoureyes/
Next Steps
Please call us to book an initial eye exam and consultation so we can go over options, expectations and co-management with your surgeon as needed.
Congenital cataracts can be strain on families. Our expertise will put you at ease and give you the confidence to know your baby’s vision is in the best possible hands.
Before you know it, your child will be independently caring for and handling their own contact lens! Your child will be very grateful for all your hard work, and we’re here to support you all the way!
