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The use of contact lenses in children with unilateral traumatic aphakia
Insights
Early contact lens fitting for children with traumatic aphakia significantly improves binocular function and amblyopia treatment. Prompt intervention with soft lenses after pupil clarity is recommended for better outcomes.
Area of Science:
- Ophthalmology
- Pediatric Optometry
Background:
- Unilateral traumatic aphakia in children under ten presents challenges for visual development.
- Contact lens fitting is a common intervention for such cases.
Purpose of the Study:
- To evaluate the long-term outcomes of contact lens use in children with unilateral traumatic aphakia.
- To assess the impact of early intervention on binocular function and amblyopia.
Main Methods:
- Retrospective review of seventeen children under ten with unilateral traumatic aphakia treated with contact lenses.
- Ophthalmological and orthoptic assessment an average of three years post-injury.
Main Results:
- Thirteen of seventeen children continued lens wear; none developed severe amblyopia.
- Twelve children exhibited heterotropia, often moderate; only one had orthophoria.
- Six children achieved stereopsis on synoptophore; four on Titmus sterotest, particularly those treated early (≤6 months) and aged ≥6 years at injury.
Conclusions:
- Early contact lens fitting is crucial for achieving better binocular function in traumatic aphakia.
- Soft lenses, fitted soon after pupil clarity, are recommended for optimal treatment of amblyopia and visual development.
Abstract:
Seveteen children under the age of ten years with unilateral traumatic aphakia, who had been fitted with contact lenses, were reviewed by an ophthalmologist and an orthoptist, on average three years after the injury. Thirteen children were still using their lenses. Of the seventeen, none were deeply amblyopic. Only one had orthophoria. Twelve of the seventeen had heterotropia, which in most cases was moderate. Six of the children achieved stereopsis in the synoptophore, only four by the Titmus sterotest, all of these were six years old or more at the time of the injury, and had had lenses fitted within the first six months of the injury. All the patients, as well as their parents, were motivated for lens-wearing, and the lens played an important part in the treatment of amblyopia. It is concluded that the sooner the contact lens is supplied, the better are the changes of obtaining binocular function. Beginning with a soft lens a few weeks after achieving clear pupil is recommended.