BLINK2 study reveals when to discontinue soft multifocal contact lens wear in pediatric patients

Jeffrey Walline, OD, PhD, FAAO, recently spoke on the primary endpoints of the Bifocal Lenses in Nearsighted Kids 2 (BLINK2) cohort study at the Collaborative Community on Ophthalmic Innovation (CCOI). The study found that no evidence of a loss of treatment effect after discontinuing multifocal contact lenses in older teenagers. At baseline for BLINK2, mean (SD) axial length and spherical equivalent refractive error were 25.2 (0.9) mm and −3.40 (1.40) D, respectively. After participants switched from multifocal to single-vision contact lenses, axial elongation increased by 0.03 mm per year (95% CI, 0.01 to 0.05) regardless of their original BLINK treatment assignment (P = .81).

Video transcript

Editor's note: This transcript has been lightly edited for clarity.

Jeffrey Walline, OD, PhD, FAAO:

I did a recent presentation on end points for studies of refractive error and myopia control. And I think the takeaways from that are that axial elongation has become a very important part of myopia control. As a matter of fact, I think we would consider it the primary outcome today. The reason that it's now the primary outcome is we have a much better understanding as a profession, and we're much better able to educate our patients about what eye growth means. So what is slow eye growth? What is fast eye growth? What are the ramifications of the eye growing too much? And it's those kinds of things that I really think help make the evolution of optometric studies and sort of change the primary focus from the progression of myopia to the growth of the eye.

So the Bifocal Lenses in Nearsighted Kids, or BLINK study, found that soft multifocal contact lenses, if you use the high reading add or the 250-add slow the progression of myopia in children. But what we've recently found is that if you discontinue those contact lenses, the rate of myopia progression will actually increase, but it only increases to a rate that is equal to those people who receive no treatment. So you don't lose the treatment effect by discontinuing contact lens wear after the age of 16, 17, 18, years of age. So our recommendation that we've always had sort of continues to stand, and that is, if you feel like you need to discontinue soft multifocal contact lens wear, wait until after the age of expected progression, after age 15 or 16, and then when you discontinue, yes, eye growth will increase, but it won't increase enough to make you lose the treatment effect that you gained by wearing those for the previous years.