Practitioner-Related Factors Influencing Pediatric Contact Lens Fitting for Myopia Management in Kenya: A Cross-Sectional Survey

ObjectiveTo examine practitioner-related factors influencing pediatric contact lens (CL) fitting for myopia management in Kenya and to identify key barriers and facilitators shaping prescribing practices. Methods and AnalysisThis cross-sectional survey involved 148 eye care practitioners (ECPs) from 38 clinics. A validated questionnaire captured demographics, clinical decision-making, and perceived enablers or barriers to pediatric CL prescribing. Data were analyzed using descriptive statistics and multivariate logistic regression at p < 0.05. ResultsMost ECPs prescribed spectacles for children under 8 years (79.1%) and initiated CLs at 13-14 years. Major facilitators were child motivation (OR = 25.04, CI: 4.36-46.03, p = 0.01), trial lens availability (OR = 2.89, CI: 1.05-5.47, p = 0.02), and perceived market opportunity (OR = 8.74, CI: 4.32-14.70, p = 0.01). Barriers included low public awareness (OR = 0.14, CI: 0.05-0.32, p = 0.01) and practitioner inexperience (OR = 0.17, CI: 0.08-0.35, p = 0.01). ConclusionsPediatric CL prescribing in Kenya remains limited by low awareness and practitioner inexperience. Availability of trial lenses and motivated young patients enhance uptake. Targeted practitioner training and community education could improve early myopia-control practices and support wider adoption of pediatric CLs. However, interpretation of these findings is limited by the self-reported nature of the practitioner data. Key Message of This Article1. What is already known on this topicChildhood myopia causes significant educational and social disadvantages. Despite its growing prevalence, pediatric contact lens prescribing remains limited in low-resource settings due to structural barriers, practitioner hesitancy, and parental concerns, while most existing evidence overlooks these systemic challenges in sub-Saharan Africa. 2. What this study addsThis study provides the first national-level analysis from Kenya quantifying how practitioner self-efficacy, parental attitudes, and trial-lens availability influence pediatric contact lens uptake. It applies a multivariate framework to isolate modifiable behavioral and structural predictors previously unexamined in this context. 3. How this study might affect research, practice, or policyThe findings generate a context-specific evidence base for advancing pediatric myopia-control programs through practitioner capacity-building, improved clinic resourcing, and integration of evidence-led policies within child eye health strategies.