A survey of attitudes and clinical behaviour of UK eyecare practitioners towards fitting contact lenses for children and young people

Purpose: This study explored the attitudes and prescribing behaviours of UK eyecare practitioners (ECPs) toward fitting contact lenses (CLs) for patients under 18, and whether these have been influenced by the growing availability of myopia control options.

Methods: An online survey was conducted in 2023 with UK-based optometrists and contact lens opticians (CLOs). It examined minimum fitting ages for different CL types, key decision-making factors when prescribing for paediatrics, and changes in practitioners' willingness to fit CLs for children. Comparisons were made to a prior iteration of the survey in 2014.

Results: A total of 316 ECPs (248 optometrists, 68 CLOs) completed the survey, with a median of 16 years of experience. Patients under age 18 comprised an estimated 37.2 % of respondents' CL patients, dropping to 6.2 % for those under age 10. All respondents considered soft CLs suitable for under-18 s, with a median starting age of 8-9 years; rigid corneal lenses were deemed suitable from a significantly higher age of 10-12 years (p < 0.001). CLOs were more willing than optometrists to fit both lens types at earlier ages (p < 0.05) and rated a child's age as less influential in decision-making (4.9/10 vs. 6.2/10 respectively, p < 0.001). In general, the child's motivation was the most important factor (9.1/10), while sex was the least (1.8/10). Myopia control was a key consideration (8.4/10), and 38.6 % of ECPs said they had greater willingness to fit CLs for children due to increased access to myopia control options. The proportion of optometrists willing to fit a child under age 8 increased from 12.7 % in 2014 to 39.1 % in 2023.

Conclusions: UK ECPs are generally supportive of CL wear in under-18 s, with myopia control increasingly influencing prescribing. CLOs appear more proactive in paediatric fittings, suggesting a need to enhance optometrists' training to improve confidence in prescribing for younger patients.