Abstract
Purpose
The relative risks of ocular pathology with increasing myopia have been described;
the absolute lifetime risk of vision impairment from myopia is yet to be compared
to the childhood and lifetime risks of contact lens wear for myopia control.
Methods
Using peer-reviewed data, the absolute risks of microbial keratitis (MK) in daily
disposable soft, reusable soft and orthokeratology contact lens (CL) wear were calculated
over both a childhood (age 8–18) and a lifetime (age 8–65) of CL wear. This was compared
to the previously published cumulative risk of vision impairment by age 75 based on
increasing myopia and axial length. Data were converted utilizing the Council of International
Organizations of Medical Sciences (CIOMS) classification system for frequency of adverse
events, with 95 % confidence intervals included.
Results
The lifetime risk of vision impairment in axial lengths over 26 mm and more than 6D
of myopia is greater than the lifetime risk of MK in any CL modality, except for adult
SCL extended wear. If axial length is below 26 mm and myopia lower than 3D, a lifetime
of CL wear is more risky in comparison, except in the case of daily disposable wear.
Ten years of childhood CL wear of any modality presents lower likelihood of MK than
any comparable risk of vision impairment.
Conclusion
The comparative lifetime risks of contact lens wear commenced at age 8 for myopia
control are less than the lifetime risks of vision impairment with myopia more than
6D or axial length more than 26 mm. When only childhood CL wear is considered, the
risk comparison is clearly skewed towards the positive impact of CL wear, especially
in daily disposable wear. Clinicians should be confident to proactively recommend
myopia control CL wear to younger children, as both the safety profile and potential
preventative ocular health benefits are evident.
Keywords
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Article info
Publication history
Published online: November 30, 2019
Accepted:
November 15,
2019
Received in revised form:
November 15,
2019
Received:
September 23,
2019
Identification
Copyright
© 2019 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
