Visual performance and quality of life in myopic adolescents with pupil-optimised multifocal versus single-vision contact lenses.

Clinical relevance: Myopia control is a prominent area of global research, with multifocal contact lenses identified as an effective intervention for adolescents.

Background: This study aims to evaluate the visual performance and vision-related quality of life (QoL) of myopic adolescents when corrected with pupil-optimised multifocal soft contact lenses (MFSCLs) versus single-vision contact lenses (SVCLs), with each participant serving as their own control.

Methods: Thirty-five myopic adolescents, habitually wearing SVCLs and fitted with pupil-optimised MFSCL with mid-addition power, were recruited. The assessment included distance visual acuity (DVA), near visual acuity (NVA), maximum reading speed (MRS), reading acuity (RA), contrast sensitivity (CS), and stereoacuity (SA) in photopic conditions for both types of lenses. Vision-related QoL was quantified twice for both lens types using the National Eye Institute Visual Function Questionnaire (NEI VFQ-42), covering 13 vision-specific domains.

Results: Comparisons of visual outcomes between MFSCLs and SVCLs for the same subjects revealed statistically significant differences in DVA (p = 0.010), NVA (p = 0.014), MRS (p = 0.044), and RA (p < 0.001), with SVCLs outperforming in DVA only. No significant difference in CS and SA was observed between the two lens types. According to the NEI VFQ-42, scores for clarity of vision, far vision, glare, and satisfaction with correction were higher with SVCLs, while the score for near vision was higher with MFSCLs. When fitted with MFSCLs, no significant correlations were found between pupil size and age of the patient with any visual examination parameters. However, there was a significant negative correlation between the DVA, NVA and the spherical equivalent of the lens.

Conclusion: MFSCLs with mid-add power significantly improve NVA, MRS, and RA, albeit with a reduction in DVA compared to SVCLs. While SVCLs were associated with better clarity of vision, far vision, and satisfaction with correction, MFSCLs offered superior performance in near vision tasks, according to the NEI VFQ-42 scores.