Adverse Contact Lens Events Common, But Not Clinically Meaningful in Children

Adverse events may arise from increased contact lens (CL) use in children for myopia progression, but the events are rarely clinically meaningful and have not resulted in discontinued lens use or best corrected visual acuity (BCVA) reduction, according to a study published in Optometry Vision Science. 

Researchers analyzed data from participants enrolled in the Bifocal Lenses in Nearsighted Kids (BLINK) study (Clinicaltrials.gov Identifier: NCT02255474) who wore soft contacts for 3 years for a mean 73.0±26.5 hours per week. The team randomly assigned participants to wear single vision, multifocal lenses with a +1.50 D add power, or multifocal lenses with a +2.50 D add power soft contact lenses on a daily wear-only basis. Researchers performed comprehensive eye examinations, cycloplegic autorefraction, and measured axial length for all children. The primary objective was to determine the frequency of both adverse ocular and nonocular events in the cohort. 

Overall, the team reported a total of 432 adverse events. They noted that 220 of the 294 participants (74.8%) encountered at least 1 adverse event. Among the total adverse events reported, 75.2% were ocular and 24.8% were non-ocular. Contact lens wear was probably or definitely related to 60.6% of the ocular and 2.8% of the non-ocular adverse events, according to the report. Investigators determined that none of the ocular adverse events were serious. The 3 most commonly diagnosed adverse effects were solution-induced corneal staining (n=91, 28.0%), ocular allergies (n=46, 14.2%), and hordeolum/chalazion (n=23, 7.1%).

Researchers suggest that most children will experience at least 1 adverse effect during soft lens wear, but state that most effects are not severe and do not permanently affect vision.

“Most children (74.8%) experienced an adverse event during the 3 years they were randomized to wear either single vision, +1.50 D add, or +2.50 D add daily wear soft contact lenses for myopia control,” according to the investigators. “Whereas the most common diagnoses for ocular adverse events were relatively innocuous (solution-induced staining, ocular allergy, and hordeola/chalazion), others of greater concern (corneal infiltrates and new corneal scars) also occurred, although at a low rate.”

Study limitations include the retroscopic categorization of diseases, influence of free contact lens products on patient compliance, and failure to consider potential confounding caused by contact lens solutions. 

Reference

Gaume Giannoni A, Robich M, Berntsen DA, et al. Ocular and nonocular adverse events during 3 years of soft contact lens wear in children. Optom Vis Sci. 2022;99(6):505-512. doi:10.1097/OPX.0000000000001902