Investigators are considering novel techniques, such as peripheral defocus (which may slow axial elongation), in the effort to control myopia, according to the report published in Optometry and Vision Science. The pilot study assessed how well participants between the ages of 8 and 11 years tolerated center-distance soft multifocal contact lenses with +2.00 D, +3.00 D, and +4.00 D add power compared with single-vision lenses.
Little is known about the threshold at which higher add power begins to affect objective and subjective visual function. This study enrolled 11 participants with baseline “noncycloplegic spherical equivalent manifest refraction” of -1.00 D to -5.00 D, <1.00 D of astigmatism, and best-corrected visual acuity for each eye of 20/25 or better. At 4 of 5 visits, children were provided, in random order, Proclear® (CooperVision, Inc.) single-vision lenses or 1 of 3 Proclear multifocal “D” contact lenses to wear for 5 to 7 days. Objective tests included distance and near acuity, contrast sensitivity, pupil diameter, and slit-lamp biomicroscopy, while subjective measurement comprised a 13-question vision survey created for this investigation.
Nine participants completed all visits, and data is based on this cohort. After wearing each of the lenses, results indicate that +2.00 D add lenses are well tolerated by children.
In high-contrast conditions, no significant differences appeared among the 4 lens types when evaluating both eyes for distance acuity (P =.37), or near logMAR acuity (P =.65). However, differences in median logMAR distance visual acuity occurred in low-contrast settings: +0.10 for single-vision lenses, +0.16 for +2.00 D add, +0.200 for +3.00 D, and +0.28 for +4.00 D lenses. In post hoc analysis, researchers noted reductions in visual acuity using the +4.00 D add compared with each of the other contacts (P <.04), but no meaningful difference between single-vision and +2.00 D add lenses.
Subjective vision quality was impacted in 5 of 10 categories. Post hoc data showed starbursts or glare from +4.00 D compared with single-vision was significant (P =.005), as well as ghost images (P =.014). For computer viewing, +2.00 D was tolerated better than +4.00 D (P =.013). When changing fixation among distances, single-vision was better than +3.00 D or +4.00 D (both P =.025). Regarding overall opinion of vision, +3.00 D was perceived as worse compared with single-vision (P =.008), and +4.00 D was considered less beneficial (P =.014). No significant differences arose between single-vision and the add lenses in categories of eye strain, lens comfort, distance vision, near work, or sporting activities.
The small sample size represents a limitation of this study, as does risk of examiner bias from being aware of lens assignment. Another limitation includes the use of only 1 type of multifocal lens.
“Practitioners should consider testing low-contrast visual acuity or contrast sensitivity to troubleshoot reported symptoms related to soft multifocal contact lens wear because they may provide a more sensitive assessment of vision-related problems,” the investigation adds.
Disclosure: Some study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Bickle KM, Mitchell GL, Walline JJ. Visual performance with spherical and multifocal contact lenses in a pediatric population. Optom Vis Sci. May 2021;98(5):483-489. doi:10.1097/OPX.0000000000001695