The risk of ocular pathology and visual impairment is high with increasing myopia, but a common myopia management method—contact lens wear—comes with its own risks. Researchers recently sought to answer whether this treatment is a safe recommendation in a younger cohort. They found that the comparative childhood and lifetime risks are indeed skewed toward the positive impact of contact lens use, especially in daily disposable wear.

The study evaluated peer-reviewed data to determine the absolute risks of microbial keratitis (MK) in daily disposable soft, reusable soft and orthokeratology contact lens wear over both a childhood (age eight to 18) and a lifetime (age eight to 65) of use. The results were then compared with previously published cumulative risk of visual impairment by age 75 based on increasing myopia and axial length data.

The team found that the lifetime risk of visual impairment in axial lengths greater than 26mm and more than 6D of myopia is greater than the lifetime risk of MK in any contact lens modality, except for soft contact lens extended wear in adults. If axial length is less than 26mm and myopia lower than 3D, however, they noted that a lifetime of contact lens wear is more risky, except in the case of daily disposable wear. They added that 10 years of childhood contact lens wear of any modality presents a lower likelihood of MK than any comparable risk of visual impairment.

“Clinicians should be confident to proactively recommend myopia control contact lens wear to younger children, as both the safety profile and potential preventative ocular health benefits are evident,” the study authors concluded in their paper. 

Gifford KL. Childhood and lifetime risk comparison of myopia control with contact lenses. Cont Lens Ant Eye. November 30, 2019. [Epub ahead of print].