Dissatisfaction and discontinuation of contact lens (CL) wear is usually attributed first to discomfort and then to vision. The two are generally considered and reported as separate entities because they represent vastly different aspects of CL wear. A new study published in Eye and Contact Lens suggests comfort and vision are actually intertwined more closely than previously thought, and the relationship between the two is dependent on lens design and the visual demands of the wearers.

Specifically, the research paper found non-presbyopic, myopic CL wearers were more inclined to link perceived comfort to vision changes, while presbyopic patients demonstrated a greater ability to separate the two.

“Quite possibly, presbyopes have come to expect compromise with vision, especially if they have previously tried older designs, monovision or have previously been advised by their eye care practitioner of a compromise,” the researchers wrote in their paper.

The study was a retrospective analysis of five clinical trials that included non-presbyopic myopes and presbyopic participants who wore various simultaneous-image designs or single-vision lenses (non-presbyopes only). One week after lens fittings, the participants answered the same vision satisfaction and clarity questionnaire and ranked from a scale of one-to-10 their perceptions of comfort and vision at distance, intermediate and near.

Based on the responses, the authors observed a trend of vision ratings correlating to comfort ratings, although this varied depending on the type of vision rating and presbyopic category. In the non-presbyopes who wore single-vision lenses, vision satisfaction influenced comfort, but this correlation was significantly lower in the presbyopic group.

In non-presbyopic participants who wore single-vision lenses, overall comfort was of greater significance and was highly associated with vision achieved with their lenses, the researchers said. This was perhaps intuitive because non-presbyopic myopic participants with minimal cylindrical power who wore standard single-vision contact lenses would be expected to have good-quality vision, they added. The study noted overall similar results when lens material was considered.

In a reverse relationship, comfort had a significant impact on vision satisfaction, although again at varying levels for each presbyopic group. Also of note: non-presbyopic single-vision wearers showed the weakest relationship in comparison with non-presbyopes and presbyopes who wore simultaneous image design lenses.

Diec J, Naduvilath T, Tilia D, et al. The relationship between vision and comfort in contact lens wear. Eye Contact Lens. 2021;47(5):271-6.