Routine examination ensures safe soft contact lens wear for young children
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Despite the potential for ocular and non-ocular adverse events related to use, soft contact lenses are a safe option for children aged 7 to 10 years who are routinely examined, according to a study in Optometry and Vision Science.
“Today, children are fit with contact lenses more often and at earlier ages, due primarily to the availability of daily disposable contact lenses,” Amber Gaume Giannoni OD, FAAO, of the University of Houston College of Optometry, and colleagues wrote. “Safety is one of the primary concerns of both parents and practitioners when fitting a child with soft contact lenses, although the rates of noninfectious inflammatory events have been shown to be comparable between children and adults.”
Seeking to document the frequency and type of ocular and non-ocular adverse events related to soft contact lens wear in children, Giannoni and colleagues evaluated 294 myopic children, aged 7 to 11 years, in the 3-year Bifocal Lenses in Nearsighted Kids (BLINK) study between September 2014 and June 2016. The study aimed to determine the rate of myopic progression in children wearing multifocal soft contact lenses compared with those wearing single vision contacts.
At enrollment, participants (60.2% girls; 68% white, 26% Hispanic, 10% Black, 9% Asian) had less than 1.00 D astigmatism and 0.75 D to 5.00 D spherical component in each eye and no more than 2.00 D of anisometropia. All were free of eye disease, systemic conditions and binocular vision problems.
Participants were randomly assigned Biofinity single vision, Biofinity multifocal “D” with a +1.50 D add power or Biofinity multifocal “D” with a +2.50 D add power (CooperVision) soft contact lenses for daily wear and were evaluated every 6 months for 3 years. Proclear or Proclear multifocal “D” (CooperVision) contact lenses were used as the primary backup lens option if initial fit was poor.
Researchers defined adverse events as slit-lamp examination findings of at least grade 3 on the Efron Grading Scale and parental and examiner reports of a clinically meaningful change in eyes, vision or health, including ocular discomfort, excessive tearing or discharge, blurry vision and headache.
According to study results, 91.8% of participants were still wearing their originally assigned lenses after 3 years, with a wear time of 73.0 ± 26.5 hours per week.
Nearly 75% of participants experienced at least one adverse event in the 3-year study period, and 51.3% experienced an adverse event most likely or definitely related to contact lens wear. Researchers reported that 50.2% of the ocular adverse events happened in the first year, followed by 27.7% in the second year and 22.1% in the third year. Conversely, 29.9% of the non-ocular adverse events occurred in the first year, followed by 24.3% and 45.8% in the second and third years, respectively.
Of 432 documented adverse events, 107 were non-ocular, and 325 were ocular. Most adverse events did not require medical treatment and did not lead to loss of best-corrected vision or discontinuation of contact lens wear. The most common diagnoses for ocular adverse events were solution-induced corneal staining, ocular allergies and hordeola/chalazia; trauma cases, systemic disease and non-vision-related headaches were the top diagnoses for non-ocular adverse events.
“Contact lenses provide a safe option for children who do not want to wear spectacles or want to try daily wear contact lenses as a method to slow the progression of myopia,” Giannoni and colleagues concluded.
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