Abstract
Purpose :
To determine the effect of binocular vision disorders (BVDs) on contact lens (CL)-dissatisfaction.
Methods :
This was a prospective study where 76 myopic, non-presbyopic CL wearers attended one visit while wearing habitual CLs.
BVD and CL discomfort (CLD) symptoms were assessed via the convergence insufficiency syndrome survey (CISS) and the contact lens dry eye questionnaire-8 (CLDEQ-8), respectively. Participants (Pxs) underwent a comprehensive BV assessment and were categorised into 3 groups according to their BV-status:
1. Normal (N): ≤2 measures outside normal range
2. Abnormal Findings (AF): ≥3 measures outside normal range but no BVD
3. BVD
CLD-status was grouped based on CLDEQ-8 score: non-CLD: ≤11 and CLD≥12.
Pxs were assessed for CL surface characteristics, CL fitting and ocular surface.
CL-dissatisfaction was assessed via the ocular surface disease index (OSDI), contact lens impact on quality-of-life (CLIQ) and ranked symptoms survey (RSS). These were emailed to Pxs at visit completion.
Subjective and clinical data were analysed using general linear model, with significance set at 5%.
Results :
BV-status: N=42, AF=17, BVD=17.
CLD-status: non-CLD=37, CLD=39.
OSDI total score was associated with BV-status (p=0.001. BVD vs N / AF (25±13: 11±8 / 10±5.5, p≤0.001) and CLD-status (p=0.003. CLD vs. non-CLD (19±12: 9.1±5.7, p=0.003). The vision subscale of the OSDI was associated with BV-status (p<0.001) but not CLD-status (p=0.33) while the ocular and environmental subscales of the OSDI were associated with CLD-status (p≤0.03) but not BV-status (p≥0.29).
CLIQ was associated with BV-status (p=0.003) but not CLD-status (p=0.09) while RSS was associated with CLD-status (p<0.001) but not BV-status (p=0.91).
CISS was associated with BV-status (p=0.001) and CLD-status (p=0.005).
CLDEQ-8 was not associated with BV-status (p>0.99)
There were no significant associations within BV-status or CLD-status for CL surface or fitting (p≥0.051), or within BV-status for ocular surface (p≥0.10). CLD had a significantly lower fluorescein tear-break-up-time than non-CLD (7.0±3.7: 10±3.6, p=0.001).
There was no significant interaction between BV-status or CLD-status for any questionnaire or clinical variable (p≥0.13).
Conclusions :
BVDs contribute to CL-dissatisfaction in addition to CLD. OSDI and its subscales are appropriate measures of CL-dissatisfaction due to BVD and CLD.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.