Pediatric Use of the Morgan Lens

The Morgan Lens has been used on children as young as six months of age.  Pediatricians have often reported that the child often will fall asleep once irrigation is started and the irrigating solution begins to soothe the injured eye.  Even adults find it difficult to fight the body’s natural reflex action and they try to squeeze the injured eye shut.  This is far more difficult for a young child who is not able to understand why someone is forcefully holding the eye open.  Unlike all other methods of eye irrigation, the Morgan Lens does not require the cooperation and assistance of the patient, making it ideal for use with infants and children.

Eye Development:
The eyes grow relatively little throughout life.  For example, the horizontal diameter of the cornea is approximately 10.0 mm in a newborn and 11.8 mm in an adult, and the dimensions of the orbit increase from 30 by 32 mm in an 18-month-old child to 33 by 39 mm in an adult.  The length of the palpebral fissure (the horizontal opening between the eyelids) increases only a few millimeters, going from about 24-25 mm in an infant to 28-30 mm by adulthood.

Since the Morgan Lens is just 23 mm in length, it can easily be slipped through the palpebral fissure into the much larger opening under the eyelids.  If necessary, the lens may be rotated slightly during insertion.

Suggestions for using the Morgan Lens on infants and children:

• Have a parent hold the child during the irrigation process
• Reassure the child (and/or parent) that insertion of the lens will quickly alleviate pain
• Use wording like “this may feel cold” or “this will be wet” rather than saying something that may cause further anxiety
• Remind everyone that the Morgan Lens does not touch the eye but floats on the irrigating solution
• Use lactated Ringer’s Solution (Hartmann’s solution) instead of Normal Saline
• During insertion, the lens may be rotated slightly to fit more easily into the smaller opening
• Studies show warmed irrigating solutions may be more comfortable for some patients
• Use of an ocular anesthetic may help relieve anxiety–additional drops may be added without removing the lens (pinch the tubing and instill drops in the cul-de-sac)