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Incidence of corneal infiltrative events low in young children
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The incidence of corneal infiltrative events in children is no higher than in adults, and in children 8 to 11 years old, rates may be even lower, according to a literature review in Optometry & Vision Science.
Nine prospective studies representing 1,800 patient years of wear in youths from 7 to 19 years old were explored.
In three large, prospective studies representing between 159 and 723 patient years of soft contact lens wear in patients 8 to 14 years old, the incidence of corneal infiltrative events was up to 136 per 10,000 years, reported author Mark A. Bullimore, MCOptom, PhD, FAAO.
Data from another large retrospective study show similar corneal infiltrative events of 97 per 10,000 years in children 8 to 12 years old and 335 per 10,000 in those 13 to 17 years old.
None of the studies reported any incidents of microbial keratitis.
The incidence of corneal infiltrative events is particularly low when the population is limited to children 12 years and younger, Bullimore wrote.
The introduction of daily disposable soft contact lenses may play a role in reducing corneal infiltrative events in all patients, including children, he concluded.
The accompanying figure, which was not published with the study, summarizes the incidence of corneal infiltrative events across a range of studies. The colored bars represent the estimated incidence, and the error bars represent the 95% confidence interval.
Bullimore explained to Primary Care Optometry News that in six large prospective studies of young children (on the left in the chart), the incidence and upper confidence interval are both markedly lower than for adults (on the right). In the retrospective Contact Lens Assessment in Youth (CLAY) study (the orange bars), the incidence is similarly low in the younger children, but at adult levels in the older children, he said.
“This is attributable to changes in behavior among teenagers – something that many parents will have observed,” Bullimore told PCON.
“I encourage all readers to digest the results of this paper and use them to present soft contact lenses – particularly daily disposable – as a safe option for children as young as 8 years,” he said. “These discussions are increasingly important as opportunities for myopia control proliferate in the coming years.” – by Abigail Sutton and Nancy Hemphill, ELS, FAAO
References:
Bullimore, MA. Optom Vis Sci. 2017;94(6):638-646;doi: 10.1097/OPX.0000000000001078.
Chalmers RL, et al. IOVS. 2011;52:6690-6696;doi: 10.1167/iovs.10-7018.
Disclosure: Bullimore reports he is a consultant to Abbott Medical Optics, Acucela, Alcon, Carl Zeiss Meditec AG, CooperVision, DigiSight, Innovega and Novartis Pharma AG. The study was supported, in part, by CooperVision.
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