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Published on: April 6, 2016
The Safety of Soft Contact Lenses in Children
1*MCOptom, PhD, FAAO University of Houston College of Optometry (MAB), Houston, Texas.
Insights
Soft contact lens wear in children shows low rates of complications. Corneal infiltrative events are comparable to adults, and microbial keratitis is rare in pediatric soft contact lens wearers.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Contact Lens Research
Background:
- Increasing interest in fitting children with soft contact lenses.
- Need to assess safety and complication rates in pediatric populations.
- Soft contact lenses offer vision correction for a growing pediatric demographic.
Purpose of the Study:
- To collate data on the incidence of soft contact lens complications in children under 18.
- Specifically review rates of corneal infiltrative events and microbial keratitis.
- Evaluate the safety of soft contact lens wear in pediatric patients.
Main Methods:
- Systematic review of peer-reviewed papers from PubMed and Web of Science.
- Inclusion of epidemiological studies, case series, and prospective/retrospective studies.
- Analysis of safety outcomes from studies representing significant patient years of wear.
Main Results:
- Nine prospective studies (1800 patient years) in 7-19 year olds reported safety outcomes.
- Corneal infiltrative events ranged from 97 to 335 per 10,000 years across age groups.
- No cases of microbial keratitis were reported in prospective studies; retrospective data showed low incidence in older children.
Conclusions:
- Incidence of corneal infiltrative events in children is comparable to adults.
- Pediatric soft contact lens wear demonstrates a favorable safety profile.
- Younger children (8-11 years) may experience even lower rates of complications.
Purpose:
There is increasing interest in fitting children with soft contact lenses. This review collates data from a range of studies to estimate the incidence of complications, specifically corneal infiltrative events and microbial keratitis, in patients under the age of 18 years.
Methods:
Peer-review papers were identified using PubMed and the Web of Science. A broad range of studies are summarized including large-scale epidemiological studies of contact lens-related complications, hospital-based case series, long- and short-term prospective studies, and multicenter retrospective studies.
Results:
Nine prospective studies representing 1800 patient years of wear in 7- to 19-year-olds include safety outcomes. In three large prospective studies representing between 159 and 723 patient years of soft contact lens wear in patients 8 to 14 years, the incidence of corneal infiltrative events is up to 136 per 10,000 years. Data from a large retrospective study show similar rates of corneal infiltrative events: 97 per 10,000 years in 8- to 12-year-olds (based on 411 patient years of wear) and 335 per 10,000 years in 13- to 17-year-olds (based on 1372 patient years of wear). None of the prospective studies report any cases of microbial keratitis. Five clinical studies where safety data are not reported constitute a further 493 patient years. One retrospective study found no cases of microbial keratitis occurred in 8- to 12-year-olds (411 patient years) and an incidence of 15 per 10,000 patient years in 13- to 17-year-olds (1372 patient years)-no higher than the incidence of microbial keratitis in adults wearing soft contact lenses on an overnight basis.
Conclusions:
The overall picture is that the incidence of corneal infiltrative events in children is no higher than in adults, and in the youngest age range of 8 to 11 years, it may be markedly lower.
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