Survey: Contact Lens Dissatisfaction Associated With Binocular Vision Disorders

Woman Having Trouble Putting On Contact Lenses
Eye care patient suffering side effects from wearing contacts
The study also found that this association was independent of contact lens discomfort (CLD).

Binocular vision disorders (BVDs) contribute to contact lens (CL) dissatisfaction independently of CL discomfort (CLD) in myopic, prepresbyopic, adult, single-vision CL wearers, according to findings published in Optometry and Vision Science.

Researchers conducted a study to determine whether CL dissatisfaction due to BVDs, if any, is independent of CLD. The study consisted of participants wearing their habitual CLs while attending 1 clinical visit in which symptoms of CLD and BVDs were measured with the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and Convergence Insufficiency Syndrome Survey (CISS), respectively. A comprehensive assessment of binocular vision (BV) was also conducted, and the Ocular Surface Disease Index (OSDI) was used to measure CL dissatisfaction from CLD and BVDs based on reported correlations between the CLDEQ-8 and the CISS with the OSDI. CL comfort status (CLD or non-CLD) and BV status (BVD or non-BVD) were used to categorize participants.

The study found that, compared with those diagnosed with non-BVD, those diagnosed with BVD (25%) scored higher for the OSDI (P <.001) and CISS (P =.001), but not for the CLDEQ-8 (P =.25). Participants in the CLD group scored higher for the OSDI (P =.003) and the CISS (P =.001) than those in the non-CLD group. No questionnaire suggested a significant interaction between BV status and CL comfort status (P >.08). 

Although no significant difference was seen within binocular vision status for the CLDEQ-8, the findings from the CISS seem to contradict this at first glance.

“Those diagnosed with a binocular vision disorder or categorized as having contact lens discomfort both scored significantly higher than those categorized as having nonbinocular vision disorder or noncontact lens discomfort, respectively, even though the CISS was chosen as the measure of binocular vision disorder symptoms,” according to the report.

Study limitations include a possible underestimation of the proportion of those with a BV disorder, since no suppression control was implemented for binocular accommodative facility. 


Tilia D, Bakaraju R, Asper L, Papas E. Associations between binocular vision disorders and contact lens dissatisfaction. Optom Vis Sci. 2021;98(10):1160-1168. doi:10.1097/OPX.0000000000001780