title: Geographic and temporal risk factors for interruptions to soft contact lens wear in young wearers.
abstract: OBJECTIVE
  This was a secondary analysis of an existing dataset of soft contact lens wearers age 8-33 years, who received eye care outside of a clinical trial. The aim was to identify geographical and temporal factors associated with interruptions to contact lens wear.
  
  
  METHODS
  Data from six academic centers in North America captured 522 events in 3549 patients. Cases were analyzed overall and in subcategories of allergic, and serious and significant adverse events. General estimating equations were used to model the effect of geographic (Northwest, West, Central, Northeast, Southeast) and temporal (season, month, day of the week) factors, along with previously identified risk factors associated with interruptions in lens wear (patient age, contact lens material, overnight wear, lens care system, replacement schedule, and years of contact lens wear).
  
  
  RESULTS
  After controlling for established risk factors, both region and temporal factors disrupted the patients' ability to maintain contact lens wear. About 4% of all visits had complications that led to an interruption in wear. Allergic events were highest in the Central region. Serious and significant adverse events peaked in the Southeast during the Autumn and Winter months (September, October, December). Day of the week was not significant in any model.
  
  
  CONCLUSIONS
  This study provides evidence of seasonal and regional challenges to contact lens wear. As the use of soft contact lenses expands for both cosmetic and medical reasons, practitioners must examine ways to maintain continuous, safe, and healthy use of contact lenses across all patients.
authors.affiliation: State University of New York College of Optometry, New York, New York, United States. KRichdale@SUNYopt.edu
authors.forename: Kathryn
authors.initials: K
authors.lastname: Richdale
authors.forename: Dawn Y
authors.initials: DY
authors.lastname: Lam
authors.forename: G Lynn
authors.initials: GL
authors.lastname: Mitchell
authors.forename: Robin L
authors.initials: RL
authors.lastname: Chalmers
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Jansen
authors.forename: Beth T
authors.initials: BT
authors.lastname: Kinoshita
authors.forename: Luigina
authors.initials: L
authors.lastname: Sorbara
authors.forename: Heidi
authors.initials: H
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001294:Attitude to Health; D001762:Blepharitis / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D003231:Conjunctivitis / Q000453:epidemiology*; D003263:Contact Lenses, Hydrophilic / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000453:epidemiology*; D008297:Male; D009656:North America / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: Complications; Corneal inflammatory events; Region; Season; Soft contact lenses