Dr. Kris Kerestan Garbig

Children…Ages 8 – 10 yrs. Preteen…Ages 11 – 12 yrs. Teen…Ages 13 – 18 yrs.

Millennials… A ges 21 – 35 Generation X…Ages 36 – 47 Boomers & Beyond…Above Age 50

 Survey completed August 2010 Studied the Prescribing habits of 576 American Optometrists when fitting Kids in Contact Lenses

 AGE FACTORS in prescribing 97% of the O.D.s surveyed said they fit CLs on patients younger than 18 years In fact, 41% of all the CL patients in their practices are actually kids under the age of 17 years

Of the 41% of Kids fit in CL: 2% were between 8-9 yrs 7% were between yrs 13% were between yrs 19% were between yrs

66% of Docs years of age 50% of Docs years of age 20% of Docs years of age

33% say due to DAILY DISPOSABLES: Why Daily Disposables? 1. Most Healthy option 2. Minimal Care/ No CL Soln’s 3. Extremely Flexible

Healthiest option: New, Fresh, Clean CL Q day No chance for buildup of protein or CL debris Best choice for Allergy patients

Minimal Care/No Solutions: Saves Time and saves Money on Solns Eliminates Soln. Related Red Eyes Eliminates Soln. Related Allergies

Extremely Flexible: Sports Dance Gymnastics Drama Swimming Other Activities

23% say due to IMPROVED CL MATERIALS: (Silicone Hydrogel)  Extremely comfortable  Increased O2 to cornea  Ease of handling  UV protection (Important to 85% parents)

19% say due to Parent or Child Request:  More awareness of benefit of CL for school and sports activities  Friends wearing CL

10% say due to Current Research on the benefits of Kids and CL wear:  Articles in Magazines – Woman’s Day, U.S. News and World Report, Ladies Home Journal  Info. on the Internet

 Interest and Motivation of the Child ( Most important factor to 96% of O.D.s)  Maturity Level  Hygiene  Parental help and support

 Ease of Handling  Oxygen Permeability  Comfort  Visual Acuity  Frequency of Replacement  UV protection

Total of 484 myopic children aged years of age Five clinical centers in the U.S. All children previously wore glasses

50% of children continued in Glasses 50% of children fit in CL’s 93 % chose Daily Disposables 7 % chose 2 Week Disposables

After 3 yrs. their Vision-Related Quality of Life was assessed using an in-depth profile questionnaire of 26 questions ( Strongly disagree to Strongly agree) Increase Q of Life of 14.2 units in CL wearers Increase Q of Life of 2.1 units in glasses wearers

Improved Self Esteem in NonVision-related areas:  Athletic Performance  Appearance  Peer Perception

Fitting Criteria used the 3 “Ms” 1.Maturity 2.Motivation 3.Mom

 Contact Lenses improve children’s quality of life in areas beyond vision including athletic performance, peer acceptance and appearance

 Lenses allow more freedom of movement, excellent peripheral (side) vision necessary for a full field of view, and less distortion than glasses because the lens sits directly on the eye.  In the classroom, clearer vision allows for deeper participation and understanding of materials

◦ Display office brochures to stimulate interest and to prepare parents and kids for a conversation about CL’s ◦ Consider keeping trials in the exam rooms as a visual reminder for you and the parent

◦ Use conversation starters... “Have you ever thought about wearing contacts?” or “Many people like wearing contacts for activities like sports, would you like to try them today?” ◦ Include both the parent AND the child in the conversation

◦ Optometric Staff must show patience and care during the initial fitting/training ◦ Send kids home with wear/care instructions

◦ On-line resources from CL manufacturers ◦ Sign up for Acu-minder ◦ Give the kids a way to communicate with the office… or cell # they can text

 Short Attention Spans (Keep exam process simple)  Small Palpebral Fissures (Choose a small diameter CL)  Developing Dexterity (Train parents insertion and removal also) * Make sure an extra care kit is given for school*

 Challenging attention spans and easily bored  Busy sports and school schedules  Increasing life responsibilities and CL care  Daily Disposables * Extra Care Kits*

KISS principle Keep It Simple Succeed

 Always give Extra Care Kits…Locker, Backpacks, Sports Bags  Compliance Contract…Signed by the CL wearer in which they take FULL responsibility for proper wear and care *Acuminder*

 Compared CL wear in Children vs. Teens  84 children between 8-12 yrs.  85 teens between yrs.  Protocol…fit, I/R training, FU 1 week, 1 month and 3 month

 Three variables were measured ◦ Eye Health ◦ Ease of Fit ◦ Quality of Life Issues

 EYE HEALTH ◦ Equal adaptation betw. Child and Teen ◦ No serious adverse effects or eye health issues  EASE of FIT ◦ Essentially the same ◦ By 3 months 83% of the children vs. 89% of teens found it easy to clean/care for CL ◦ By 3 months little if any parental assistance was needed

 Quality of Life improved in ALL areas ◦ Activities ◦ Satisfaction ◦ Appearance ◦ Peer Perceptions ◦ Overall Vision ◦ Far Vision

 Millennials- Age  Gen. X.- Age  Boomers &Beyond- Above Age 50

Characteristics:  Age  56% wear CL  CL wearer from earlier age

Characteristics:  Tech Savvy -“Grown up” with technology  Active lifestyles  Self Educating ( Internet )

Visual Needs:  Maintain clear and comfortable vision  Maintain active lifestyle

Best CL options:  Daily disposables  Two week disp.  One month disp.

PT Wearers:  Special occasions  Weekend trips  Wedding  Swimming  Beach vacation  Sports FT Wearers:  Everyone!  Dry Eye  Allergies  Hairdressers  Bartenders  Construction  Pilots  Flight Attendants

 Erratic schedules  New moms  Shift workers  Med. School residents  Frequent travelers  Firefighters  EMS  Police officers

Characteristics:  Between ages  30% wear CL  CL wearer from earlier age… 92% want to stay in CL

Computers Digital cameras Mobile Phones Digital camcorders Characteristics:  Tech Savvy  Learned technology in late teens to early 20’s and have witnessed technological advancements  Active Lifestyle

Visual Signs:  Moving reading material away  Use of bright lights  Avoiding small print

Visual Symptoms:  Eye Strain before BLUR  Tired eyes  Difficulty focusing

Visual Symptoms:  Headache  Eye Fatigue  Burning & watering  Dry Eye

Visual needs:  Maintain active lifestyle  Maintain freedom and flexibility  Maintain confidence

Visual Needs:  Maintain youthful appearance  Maintain clear and comfortable vision

 Maintain Clear Vision Reading paper Computer/Internet Cell phone/Texting Mobile Internet Ipod/MP3 GPS Read a menu

 90% use the Internet  Spend at least 8 hrs. per week on line  82% use a cell phone  Average 236 texts per month

Best Candidates:  Good motivation  Realistic expectations  Healthy ocular surface

 Discuss symptoms early, educate and set expectations  Present treatment options 3-5 yrs before age 40 Mono.= Talking w/ one person at a time Multi.= Talking w/ one person in a crowd  Treat any underlying DES  Use SiHy CL to increase O2

Best treatment options:  Multifocal CL - Daily or Planned Replacement  Monovision - Daily or Planned Replacement  Distance + Single Vision Near rx.

 Do you find wearing glasses to be a hassle? Motivation factor  Would you be able to accept a CL that meets your visual needs for only 80% of your daily tasks? Expectation factor

Outstanding Growth Opportunity:  56% of yr olds wear CL  Only 30% of yr olds wear CL (Decrease of 26%)

Characteristics:  Age 50 and above  Only 11% wear CL  Already wear multifocals or reading glasses 

Characteristics:  Learned technology in late 20s/early 30s  Need for near correction  80% interested in multifocal CL

Visual Signs: (Similar to Eps)  Moving reading material away  Use of bright lights  Avoiding small print

Best Candidates:  Good motivation  Realistic expectations  Healthy ocular surface

 E ducate and set realistic expectations  Present treatment options Mono.= Talking w/ one person at a time Multi.= Talking w/ one person in a crowd  Treat any underlying DES  Use SiHy CL to increase O2

Best treatment options:  Multifocal CL - Daily or Planned Replacement  Monovision - Daily or Planned Replacement  Distance + Single Vision Near rx.

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