Young Children:  Filtered Eyewear Vs. Contact Lenses

Filters from the Onset of Diagnosis: From the onset of achromatopsia, young children should be evaluated for filters in their eyewear.  Until the child is old enough to be considered for filtered soft contact lenses, eyewear with adequate filters must be employed. If we control the glare, the child can function at his or her maximum potential. Without adequate filters, the child may be more impaired and educators may misjudge the child’s visual potential.

The eight-year-old young lady to the right shows the severe squinting of an achromat in a bright room.


Children Need Both Inside and Outside Filters: Remember!  From dim inside lighting to bright summer sun can be a 300 times or more increase in light energy. The same filters cannot be effective for both inside and outside.

The Inside Filter: The inside filter should be dark enough to allow the child to be comfortable in the classroom. In Rod monochromats, the red filter for the eyewear works the best.  In Blue cone monochromats, magenta filters work well.  Filters must be customized to each child. Too dark a filter may affect reading vision; while too light a filter will wash out the child’s vision in a bright classroom.

Here to the left, we see the same eight year old above with red filtered eyewear.

The Outside Filter:  The filter for outside wear may be a separate pair of prescription eyewear or a non-prescription filter worn over the inside eyewear.  Transition filters are not dark enough for achromatopsia patients.  Dark red and plum filters are effective for many Rod monochromats while dark magenta filters are often helpful for Blue cone monochromats.  These filters must be much darker than the inside filtered eyewear.

On the right, we see the same eight year old with a dark plum prescription sun filter for outside wear.

Soft Contacts Lens Filters:  The point at which soft contact lenses can be prescribed will vary with the ability and maturity of the child, and the willingness of parents to help on insertion and removal in young children.  We frequently begin fitting children at about age 8 to 10 years of age and up. Younger children are fit on a case-by-case basis.  By age 10 to 13, many children become more concerned about appearance and seek filtered contact lenses over the red filters in eyewear. It is important to have the child motivated to try contact lenses in order to be successful.  Changing to filtered contact lenses can lessen the social impact of looking different caused by wearing dark filtered eyewear inside.