Pediatric Patients Who Are Male or Have Esophoria Found Less Compliant to Contacts

Contact lenses can help manage myopia progression in pediatric patients, if they’d only wear them. Throughout the academic literature, clinical researchers note a widespread lack of compliance in this patient group. A study published in Contact Lens & Anterior Eye helps pinpoint some of the nonadherence factors in single vision and myopia control contact lens patients. These factors include male sex, lower high-contrast visual acuity, and esophoria. Ocular comfort and subjective levels of visual quality also contribute to noncompliance.

The double masked, randomized clinical trial included 379 pediatric patients from 8 years old to 13 years old and with spherical equivalent cycloplegic refraction of between -0.75 D and -3.50 D. Participants wore either a single vision silicone hydrogel (SiH) lens (control lens), 2 antimyopia SiH lenses that incorporated relative plus central and periphery in a stepped manger (test lens I and II), and 2 extended depth focus hydrogel lenses (test lens III and IV).

During follow up visits, participants completed a questionnaire that gathered information about wear days per week as well as subjective measures of ocular comfort and visual quality. Participants were grouped as “adherent” when the lens was worn for more than 6 days per week, and “non-adherent” if the lens was worn for less than 5 days.

Upon analysis, 79.6% of participants who had the control lens were adherent compared with 63.7% to 74.6% with test lenses (P =.26). It was also noted that participants labeled as nonadherent were more likely to discontinue (P <.001). Male participants (P =.031) and patients with non-myopic parents (P =.031). Patients with lower baseline myopia and esophoria were also more likely to be non-adherent. Other significant factors in nonadherence were subjective ratings of lens comfort and visual comfort while using the lenses.

Limitations of the study include the fact that it was self-administered, which may overestimate adherence, the fact that it asked the wearer to average their experience rather than provide a true picture, and that it was all based on a single question.

Reference

Weng R, Naduvilath T, Philip K, Chen X, Sankaridurg P. Exploring non-adherence to contact lens wear schedule: Subjective assessments and patient related factors in children wearing single vision and myopia control contact lenses. Cont Lens Anterior Eye. December 4, 2020. 4:S1367-0484(20)30208-3. doi:10.1016/j.clae.2020.11.015.