One method being studied to slow myopia progression is the use of distance center bifocal soft contact lenses. Animal studies show that the peripheral retina plays more of a role in regulating eye growth than was previously thought. They also show that it is myopic defocus that slows this eye growth. By using distance center bifocal soft contact lenses, the central portion of the lens provides good focus of light to the central retina. The peripheral part of the lens provides near vision with light focused in front ofthe peripheral retina thus creating myopic blur.
This study is designed to determine if children can tolerate bifocal soft contact lenses in future treatments for myopia control. Typically, bifocal soft contact lenses tend to
slightly compromise acuity in adult wearers because they correct two different ranges of vision. We want to find out if children are bothered by this and to make sure the pediatric subjects can tolerate constantly wearing a near add. Therefore, we are comparing the change in quality of life when children switch from spectacles to soft spherical contact lenses or bifocal soft contact lenses. Historical data for age-and gender-matched soft spherical contact lens wearers will be
used for comparison between the two modalities.
We fitted 27 pediatric subjects in bifocal soft contact lenses and administered the Pediatric Refractive Error Profile (PREP) for Glasses at their baseline visit and the PREP Survey for Contact Lenses at the 1 month visit. Previously, 27 control
subjects completed the same surveys in the same time period while wearing soft spherical contact lenses instead.
The PREP survey consists of 26 statements based on vision-related functioning and well-being in children with some level of refractive error. Scores are scaled from zero(poor quality of life) to 100 (good quality of life), and an overall PREP score is the mean score of all of the statements. Results from this survey allowed us to compare how overall composite scores and scale scores differed between spectacle and contact lens wearers as well as between soft contact lens and bifocal soft contact lens wearers.
Our data suggest that children were tolerable of bifocal soft contact lenses. The overall composite score for the PREP showed an increase after one month of bifocal soft contact lenses wear (Student’s t test, p <0.001) and after soft contact lens wear (Student’s t test, p = 0.004). However, there was not a significant difference in the change from baseline to one month between soft bifocal and soft spherical contact lens wearers (Student’s t test, p 0.59). Mean scores for each scale of the PREP survey rose after one month of bifocal soft contact lens wear, with the greatest improvements in the scales of Satisfaction and Activities (Student’s t test, p < 0.005 for both).
The quality of life changes with soft contact lenses were similar to the changes following bifocal soft contact lens wear, which shows that bifocal soft contact lenses are a viable option to test in future studies of myopia control in children.