Impact of Multifocal Soft Contact Lenses on Shape Discrimination Threshold under Glare in Myopic Children

Cuiting Huang¹Xiuting Li²Jufen Liu³Jingjing Wu¹Yuqing Wang¹Lingli Lin¹Jinfeng Zhang¹Yanrong Chen¹Zhaode Zhang^1*Li Li^4*

• ¹Ophthalmology Department, Ningde City Hospital, Affiliated to Ningde Normal University, Ningde, China
• ²Ophthalmology Department, of Xiamen Children's Hospital, Xiamen, China
• ³Ophthalmology Department, Shangyu People's Hospital of Shaoxing City, Shaoxing, China
• ⁴Ophthalmology Department, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China

Background: Multifocal soft contact lenses (MFSCLs) are widely used to control myopia progression in children. However, their optical design may affect visual quality, especially under glare conditions, potentially influencing daily visual performance.To evaluate the impact of MFSCLs on shape discrimination threshold (SDT) under glare in myopic children by comparing changes in SDT under glare and non-glare conditions, with both MFSCLs and single vision spectacles.Methods: Thirty-seven myopic children (37 eyes) were enrolled and fitted with both MFSCLs and single vision spectacles for binocular myopia correction. Assessments included uncorrected and corrected visual acuity, corneal curvature, pupil diameter in a dark environment, and shape discrimination threshold (SDT) with glare (SDTon) and without glare (SDToff). Measurements from the right eye were analyzed. Shape discrimination thresholds (SDTs) were compared between lens types and lighting conditions, and correlations with ocular parameters were evaluated.Results: All participants achieved optimal MFSCL fit. No significant difference in SDTon or SDToff was observed between MFSCLs and spectacles (P > 0.05). However, SDTs were significantly elevated under glare compared to non-glare conditions (P < 0.001). In the MFSCL group, SDTon was significantly correlated with pupil diameter in the dark (r = 0.336, p = 0.042), as was the glareinduced SDT change (SDTdiff) (r = 0.354, p = 0.032). In the spectacle group, SDTdiff was significantly associated with spherical equivalent refractive error (r = 0.435, p = 0.007). No serious adverse events occurred, and mild corneal staining resolved with appropriate care.MFSCLs did not significantly worsen SDTs under glare in myopic children compared to spectacles, suggesting they do not exacerbate disability glare. These findings support the continued clinical use of MFSCLs for myopia management without compromising visual performance under glare conditions.