Struggle with hydrogel CL wear increases with age in young adults.
To report the symptoms and experiences associated with habitual hydrogel (Hyd) and silicone hydrogel (SiHy) contact lenses (CLs) among young adults and measure their association with age. Questionnaire responses from 699 Hyd and 183 SiHy wearers were analyzed to test the association of age with features indicating struggle with CL wear. Prevalence by age was compared between groups with Pearson's chi-square and within groups with Spearman's correlation coefficient. Hyd and SiHy groups were similar for sex and age distribution. Diagnosis of dry eye increased with age in the Hyd wearers from 10.6% to 21.1% (18-24 vs. 30-35 years), but was approximately 19% in the SiHy wearers across age. Adverse environments caused more discomfort with Hyd than SiHy lenses and Hyd wearers' discomfort increased with age (smoky (p=0.0001), dry air environments (p=0.002), after napping or sleeping (p=0.004). More Hyd wearers considered discontinuation of CL wear with age, from 4.6% to 14.2% (18-24 vs. 30-35 years, p<0.04), but the proportion remained steady at 9% across age for SiHy wearers (p=0.46). From 18 to 35 years, hydrogel CL wearers reported increasing struggle with CL wear and more negative ratings compared to SiHy wearers. Older hydrogel CL wearers were also more likely to consider discontinuing CL wear compared with younger hydrogel or silicone hydrogel CL wearers in general. Young adult CL wearers should be routinely queried directly about specific aspects of CL wear in order to determine whether different lens types should be prescribed to avoid abandonment of CL wear.