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Lynette Dias, Ruth E. Manny, Erik Weissberg, Karen D. Fern, COMET Study Group; Contact lens use and self-esteem in myopic participants in the Correction of Myopia Evaluation Trial (COMET). Invest. Ophthalmol. Vis. Sci. 2012;53(14):4448.
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To evaluate whether contact lens (CL) use was associated with self-esteem in myopic children originally enrolled in the Correction of Myopia Evaluation Trial (COMET), that after five years continued as a longitudinal, observational study of myopia progression and CL use was allowed.
Data collection at the 6-year visit (n = 435/469, age 12-17 years) included questions on CL use, refractive error (RE) by cycloplegic autorefraction and self-esteem in five specific areas (e.g., physical appearance, social acceptance) as well as global self-worth. Self-esteem, scored from 1(low) to 4(high), was measured by the Self-Perception Profile for Children (SPPC; Harter 1985) in participants under 14 years (n=66) or the Self-Perception Profile for Adolescents (SPPA; Harter 1988), in those 14 years and older (n=369). Multiple regression analyses were used to evaluate associations between self-esteem and relevant factors identified by univariate analyses (e.g., CL use, gender, ethnicity), while also adjusting for baseline self-esteem prior to CL use.
Mean (±SD) self-esteem scores at the 6-year visit (mean age=15±1.3 years; mean RE= -4.6 ±1.5D) ranged from 2.74 (± 0.75) on athletic competence to 3.34 (± 0.52) on global self-worth. CL users (n=228) compared to non-users (n=207) were more likely to be girls than boys (p<0.01). Those who chose to wear CLs after 5 years had higher baseline self-esteem (assessed by the SPPC) scores on social acceptance, athletic competence and behavioral conduct (p < 0.05) than non-users. CL users continued to report higher self-esteem at the 6-year visit on social acceptance (p< 0.05) but not athletic competence or behavioral conduct, after adjusting for baseline self-esteem. Ethnicity was also independently associated with social acceptance in the multivariate analyses; African-Americans had higher social acceptance scores than Asians, Whites or Hispanics (p< 0.01). Age and RE were not associated with self-esteem or CL use. The frequency of CL wear was also not related to any self-esteem domain.
CL users reported higher social acceptance scores than non-users 6 years prior to CL use and up to 1 year following it. This suggests that caution should be used when attributing differences in self-esteem solely to CLs.
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