Patient age, years of lens wear, use of multipurpose care products, silicone hydrogels, and extended wear were all significantly associated with CIEs with SCL wear. Use of SCLs in young patients aged 8 to 15 years was associated with a lower risk of infiltrative events compared with teens and young adults. In terms of safety outcomes, SCLs appear to be an acceptable method of delivering optics designed to manage myopia progression in children and young teens in the future.

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Patient age influences lens wearing behaviors, environmental exposures, and other determinants of health that may contribute to increased CIEs in younger wearers. Targeted, age-specific education should be considered for both new and established SCL wearers.

Purpose To understand soft contact lens (SCL) and gas permeable lens (GP) wearers’ behaviors and knowledge regarding exposure of lenses to water. Methods The Contact Lens Risk Survey (CLRS) and health behavior questions were completed online by a convenience sample of 1,056 SCL and 85 GP wearers age 20–76 years. Participants were asked about exposing their lenses to water and their understanding of risks associated with these behaviors. Chi-square analyses examined relationships between patient behaviors and perceptions. Results GP wearers were more likely than SCL wearers to ever rinse or store lenses in water (rinsing: 91% GP, 31% SCL, p<0.001; storing: 33% GP, 15% SCL p<0.001). Among SCL wearers, males were more likely to store (24% vs 13%, p=0.003) or rinse (41% vs 29%, p=0.012) their lenses in water. Showering while wearing lenses was more common in SCL wearers (86%) than GP wearers (67%) (p<0.0001). Swimming while wearing lenses was reported by 62% of SCL wearers and 48% of GP wearers (p=0.027). Wearers who rinsed (SCL; p<0.0001, GP; p=0.11) or stored lenses in water (SCL; p<0.0001, GP p=0.007) reported this behavior had little or no effect on their infection risk, compared with those that did not. Both SCL (p<0.0001) and GP wearers (p<0.0001) perceived that distilled water was safer than tap water for storing or rinsing lenses. Conclusion Despite previously published evidence of Acanthamoeba keratitis’ association with water exposure, most SCL, and nearly all GP wearers regularly expose their lenses to water, with many unaware of the risk.

PURPOSE. The purpose of this study was to assess risk factors associated with soft contact lens (SCL)-related corneal infiltrative events (CIEs).METHODS. This was a single-visit, case-control study conducted at five academic centers in North America. Cases were defined as current SCL wearers with a symptomatic CIE. For each case, three age-and sex-matched controls were enrolled. Subjects completed the Contact Lens Risk Survey (CLRS), a standardized scripted medical interview, supplied a recent health history, and underwent an ocular examination. Microbial culturing of the ocular surface, SCL, and lens storage case was conducted for all cases and one of the three matched controls. Univariate and multivariate logistic regression modeling were used to assess the risk of developing a CIE.RESULTS. Thirty cases and 90 controls 13 to 31 years of age completed the study. Corneal infiltrative event diagnosis included contact lens-associated red eye, infiltrative keratitis, and contact lens peripheral ulcer. Subjects with symptomatic CIEs were more likely to harbor substantial levels of gram-negative bioburden on the ocular surface and contact lens. Significant risk factors for developing a CIE were overnight wear of SCLs, use of multipurpose solution, rinsing SCLs with water, lens storage case older than 6 months, previous ''red eye'' event, use of ocular drops in the past week, and illness during the past week.CONCLUSIONS. This pilot study demonstrated feasibility of enrolling a representative pool of SCL wearers with an untreated, symptomatic CIE and assessing CIE risk factors by using standardized methods. A larger sample size is needed to determine relationships between patient-reported behaviors and exposures, microbial bioburden, and CIE development.Keywords: adverse events, contact lenses, corneal infiltrative events, microbial culturing A recent report from the US Centers for Disease Control and Prevention (CDC) called to light the substantial burden associated with contact lens-related complications.1 The CDC report estimated that contact lens-related keratitis results in nearly 1 million doctor visits each year and carries an associated cost of $175 million.1 This estimate does not include the additional ''costs'' to the patient such as pain or discomfort, missed school or work, and potential for permanent loss of vision.Approximately 37 million people in the United States currently wear contact lenses and, due to the increasing prevalence of myopia, more and younger patients are expected to begin wearing contact lenses to aid in its management. 2,3 Research has demonstrated that adult and pediatric patients can safely wear soft contact lenses (SCLs) within controlled trials, with relatively low rates of complications, especially for daily lens wear. 4,5 However, as with most medical devices, when contact lenses are used by the general population outside of controlled trials, the rate and types of complications increase. 1,[6][7][8] The increased risk of complications is likely caused by poor wear and care beha...