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.
"The brain's visual system is not fully mature until about age eight," says Natalia Uribe, an optometrist who directs the Contact Lens Program in The Vision Center at Childrens Hospital Los Angeles. "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."
More infants are being diagnosed with major eye problems, Uribe says, due to better screening and because of an increased rate of survival among extremely pre-term infants.
Premature infants are at risk for retinopathy of prematurity, 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 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 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, so insurance typically covers at least some of the cost.
Although parents are generally scared to insert the lenses at first, Uribe says they quickly develop ways of coping. As the child grows, he/she often becomes responsible for his/her own lenses at age 7 or 8.