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Multicenter Testing of a Risk Assessment Survey for Soft Contact Lens Wearers With Adverse Events: A Contact Lens Assessment in Youth Study

Sorbara, Luigina, O.D., M.Sc.; Zimmerman, Aaron, B., O.D., M.S.; Mitchell, G., Lynn, M.A.S.; Richdale, Kathryn, O.D., Ph.D.; Lam, Dawn, Y., M.Sc., O.D.; Kinoshita, Beth, T., O.D.; Chalmers, Robin, L., O.D.; Wagner, Heidi, O.D., M.P.H.

Eye & Contact Lens: Science & Clinical Practice: January 2018 - Volume 44 - Issue 1 - p 21–28
doi: 10.1097/ICL.0000000000000305

Purpose: To test the ability of responses to the Contact Lens Assessment in Youth (CLAY) Contact Lens Risk Survey (CLRS) to differentiate behaviors among participants with serious and significant (S&S) contact lens–related corneal inflammatory events, those with other events (non-S&S), and healthy controls matched for age, gender, and soft contact lens (SCL) wear frequency.

Methods: The CLRS was self-administered electronically to SCL wearers presenting for acute clinical care at 11 clinical sites. Each participant completed the CLRS before their examination. The clinician, masked to CLRS responses, submitted a diagnosis for each participant that was used to classify the event as S&S or non-S&S. Multivariate logistic regression analyses were used to compare responses.

Results: Comparison of responses from 96 participants with S&S, 68 with non-S&S, and 207 controls showed that patients with S&S were more likely (always or fairly often) to report overnight wear versus patients with non-S&S (adjusted odds ratio [aOR], 5.2; 95% confidence interval [CI], 1.4–18.7) and versus controls (aOR, 5.8; CI, 2.2–15.2). Patients with S&S were more likely to purchase SCLs on the internet versus non-S&S (aOR, 4.9; CI, 1.6–15.1) and versus controls (aOR, 2.8; CI, 1.4–5.9). The use of two-week replacement lenses compared with daily disposables was significantly higher among patients with S&S than those with non-S&S (aOR, 4.3; CI, 1.5–12.0). Patients with S&S were less likely to regularly discard leftover solution compared with controls (aOR, 2.5; CI, 1.1–5.6).

Conclusions: The CLRS is a clinical survey tool that can be used to identify risky behaviors and exposures directly associated with an increased risk of S&S events.

School of Optometry and Vision Science (L.S.), University of Waterloo, Waterloo, ON, Canada; College of Optometry (A.B.Z., G.L.M.), The Ohio State University, Columbus, OH; College of Optometry (K.R.), State University of New York, New York, NY; Southern California College of Optometry (D.Y.L.), Marshall B. Ketchum University, Fullerton, CA; College of Optometry (B.T.K.), Pacific University, Forest Grove, OR; Clinical Trial Consultant (R.L.C.), Atlanta, GA; and College of Optometry (H.W.), NOVA Southeastern University, Ft. Lauderdale, FL.

Address correspondence to Luigina Sorbara, O.D., M.Sc., School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada; e-mail:

The authors have no funding or conflicts of interest to disclose.

Accepted May 16, 2016

© 2018 Contact Lens Association of Ophthalmologists, Inc.