Myopia, contact lens use and self‐esteem

Abstract

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 5years continued as an observational study of myopia progression with CL use permitted. Usable data at the 6-year visit, one year after CL use was allowed (n=423/469, age 12-17years), included questions on CL use, refractive error measurements and self-reported self-esteem in several areas (scholastic/athletic competence, physical appearance, social acceptance, behavioural conduct and global self-worth). Self-esteem, scored from 1 (low) to 4 (high), was measured by the Self-Perception Profile for Children in participants under 14years or the Self-Perception Profile for Adolescents, in those 14years and older. 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 adjusting for baseline self-esteem prior to CL use. Mean (±S.D.) self-esteem scores at the 6-year visit (mean age=15.3±1.3years; mean refractive error=-4.6±1.5D) ranged from 2.74 (± 0.76) on athletic competence to 3.33 (± 0.53) on global self-worth. CL wearers (n=224) compared to eyeglass wearers (n=199) were more likely to be female (p<0.0001). Those who chose to wear CLs had higher social acceptance, athletic competence and behavioural conduct scores (p<0.05) at baseline compared to eyeglass users. CL users continued to report higher social acceptance scores at the 6-year visit (p=0.03), after adjusting for baseline scores and other covariates. Ethnicity was also independently associated with social acceptance in the multivariable analyses (p=0.011); African-Americans had higher scores than Asians, Whites and Hispanics. Age and refractive error were not associated with self-esteem or CL use. COMET participants who chose to wear CLs after 5years of eyeglass use had higher self-esteem compared to those who remained in glasses both preceding and following CL use. This suggests that self-esteem may influence the decision to wear CLs and that CLs in turn are associated with higher self-esteem in individuals most likely to wear them.