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Purpose: To validate Pediatric Refractive Error Profile 2 (PREP2) subscales that can be used to evaluate contact lens wearers and compare vision‐specific quality of life measurements between children wearing multifocal and single vision contact lenses for 2 weeks. Methods: Two hundred and ninety‐four myopic children aged 7–11 years (inclusive) were enrolled in the 3‐year, double‐masked Bifocal Lenses In Nearsighted Kids (BLINK) Study. Participants completed the PREP2 survey after having worn contact lenses for 2 weeks. The Vision, Symptoms, Activities and Overall PREP2 subscales were used to compare participants' subjective assessment while wearing +1.50 or +2.50 D add multifocal or single vision contact lenses. Rasch analysis was used to validate each subscale and to compare participants' subjective assessment of contact lens wear. Results: Item fit to the Rasch model was good for all scales, with no individual items having infit mean square statistics outside the recommended range (0.7–1.3). Response category function was acceptable for all subscales, with ordered category thresholds. Measurement precision, assessed by the Rasch person reliability statistic, was less than ideal (≥0.8) for three of the subscales, but met the minimum acceptable standard of 0.5. Scores for the Vision subscale differed by treatment assignment (p = 0.03), indicating that participants with the highest add power reported statistically worse quality of vision, although the difference was only 3.9 units on a scale of 1–100. Girls reported fewer symptoms than boys (p = 0.006), but there were no other differences between boys and girls. Conclusions: Rasch analysis demonstrates that the PREP2 survey is a valid instrument for assessing refractive error‐specific quality of life. These results suggest that vision‐related quality of life is not meaningfully affected by 2 weeks of soft multifocal contact lens wear for myopia control. [ABSTRACT FROM AUTHOR]

Children born to myopic parents have the longer eyes associated with myopia even before myopia has set in. Juvenile onset myopia usually develops between the ages of 8 and 14, and affects 15% of all children by the time they reach 15. The refractive error, corneal curvature, crystalline lens power and axial ocular dimensions of 716 first, third and sixth grade students were measured. Of these students, 180 had two parents with myopia, 316 had one parent with myopia and 220 had no myopic parents. Of those with two myopic parents, 12.2% were myopic. Of those with one myopic parent, 8.2% were myopic and of those without a myopic parent, 2.7% were myopic. Non-myopic children with two myopic parents had longer eyes, including longer anterior and vitreous chambers, and weaker crystalline lens power than the other children. Those with one myopic parent had longer eyes than those with no myopic parents., Objective. - To evaluate whether eye size and shape are different in children based on their parental history of myopia. Design. - A community-based cohort study of schoolchildren (aged 6 to 14 years), the Orinda (Calif) Longitudinal Study of Myopia. Setting. - Four campuses of the Orinda Union School District, a predominantly white, high socioeconomic status community. Participants. - A cross-sectional volunteer sample of 716 children (662 nonmyopic) in the first, third, and sixth grades in 1989,1990, and 1991. All children in those grades were eligible for inclusion in the study. Intervention(s). - None. Main Outcome Measures. - Refractive error (measured by autorefraction), corneal curvature (measured by photokeratoscopy), crystalline lens power (measured by video phakometry), and axial ocular dimensions (measured by ultrasonography). Results. - With prevalent cases of myopia excluded and grade in school and "near work" controlled for, children with two myopic parents had longer eyes and less hyperopic refractive error (analysis of covadance, P [less than or equal to] .0l) than children with only one myopic parent or no myopic parents. A model incorporating parental history is only improved by the addition of near work for the prediction of refractive error. Conclusions. - Even before the onset of juvenile myopia, children of myopic parents have longer eyes. These results suggest that the premyopic eye in children with a family history of myopia already resembles the elongated eye present in myopia.

Importance: Slowing myopia progression could decrease the risk of sight-threatening complications.Objective: To determine whether soft multifocal contact lenses slow myopia progression in children, and whether high add power (+2.50 D) slows myopia progression more than medium (+1.50 D) add power lenses.Design, Setting, and Participants: A double-masked randomized clinical trial that took place at 2 optometry schools located in Columbus, Ohio, and Houston, Texas. A total of 294 consecutive eligible children aged 7 to 11 years with -0.75 D to -5.00 D of spherical component myopia and less than 1.00 D astigmatism were enrolled between September 22, 2014, and June 20, 2016. Follow-up was completed June 24, 2019.Interventions: Participants were randomly assigned to wear high add power (n = 98), medium add power (n = 98), or single-vision (n = 98) contact lenses.Main Outcomes and Measures: The primary outcome was the 3-year change in cycloplegic spherical equivalent autorefraction, as measured by the mean of 10 autorefraction readings. There were 11 secondary end points, 4 of which were analyzed for this study, including 3-year eye growth.Results: Among 294 randomized participants, 292 (99%) were included in the analyses (mean [SD] age, 10.3 [1.2] years; 177 [60.2%] were female; mean [SD] spherical equivalent refractive error, -2.39 [1.00] D). Adjusted 3-year myopia progression was -0.60 D for high add power, -0.89 D for medium add power, and -1.05 D for single-vision contact lenses. The difference in progression was 0.46 D (95% CI, 0.29-0.63) for high add power vs single vision, 0.30 D (95% CI, 0.13-0.47) for high add vs medium add power, and 0.16 D (95% CI, -0.01 to 0.33) for medium add power vs single vision. Of the 4 secondary end points, there were no statistically significant differences between the groups for 3 of the end points. Adjusted mean eye growth was 0.42 mm for high add power, 0.58 mm for medium add power, and 0.66 mm for single vision. The difference in eye growth was -0.23 mm (95% CI, -0.30 to -0.17) for high add power vs single vision, -0.16 mm (95% CI, -0.23 to -0.09) for high add vs medium add power, and -0.07 mm (95% CI, -0.14 to -0.01) for medium add power vs single vision.Conclusions and Relevance: Among children with myopia, treatment with high add power multifocal contact lenses significantly reduced the rate of myopia progression over 3 years compared with medium add power multifocal and single-vision contact lenses. However, further research is needed to understand the clinical importance of the observed differences.Trial Registration: ClinicalTrials.gov Identifier: NCT02255474. [ABSTRACT FROM AUTHOR]