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Age, Behavior, Environment, and Health Factors in the Soft Contact Lens Risk Survey

Wagner, Heidi*; Richdale, Kathryn; Mitchell, G. Lynn; Lam, Dawn Y.§; Jansen, Meredith E.; Kinoshita, Beth T.**; Sorbara, Luigina§; Chalmers, Robin L.** for the CLAY Study Group

doi: 10.1097/OPX.0000000000000164
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Purpose Previous studies have reported that the risk of corneal infectious and inflammatory events (CIEs) with soft contact lens (SCL) wear is highest in late adolescence and early adulthood. This study assesses the associations between patient age and other factors that may contribute to CIEs in young SCL wearers.

Methods After ethics approvals and informed consent, a nonclinical population of young SCL wearers was surveyed in five US cities. Data from 542 SCL wearers aged 12–33 years were collected electronically. Responses were analyzed by age bins (12–14, 15–17, 18–21, 22–25, 26–29, and 30–33 years) using chi-square test.

Results The cohort was 34% male and balanced across age bins. There were several significant associations between survey response and age (in bins). Wearers aged 18–21 years reported more recent nights with less than 6 hours of sleep (p < 0.001), more colds/flu (p = 0.049), and higher stress levels (p < 0.001). Wearers 18–21 and those 22–25 years were more likely to wear SCLs when showering (p < 0.001) and also reported more frequent naps with SCLs (p < 0.001). They reported sleeping in SCLs after alcohol use (p = 0.031), when traveling (p = 0.001), and when away from home (p = 0.024). Lower rates of regular hand washing before lens application (p = 0.054) was also associated with these groups. In addition, the relationship between reactive replacement and recommended replacement was dependent on age (p < 0.0001).

Conclusions 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.







College of Optometry (HW), Nova Southeastern University, Ft. Lauderdale, Florida; College of Optometry (KR), State University of New York, New York, New York; College of Optometry (GLM), Ohio State University, Columbus, Ohio; Southern California College of Optometry at Marshall B. Ketchum University (DYL), Fullerton, California; School of Optometry (MEJ), Indiana University, Bloomington, Indiana; College of Optometry (BTK), Pacific University, Forest Grove, Oregon; School of Optometry (LS), University of Waterloo, Waterloo, Ontario, Canada; and Atlanta, Georgia (RLC).

Heidi Wagner Nova Southeastern University 3200 South University Dr Ft. Lauderdale, FL 33328 e-mail:

© 2014 American Academy of Optometry