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Background: Besides medical use, cosmetic contact lens (CL) use, associated with several ophthalmological risks, is gaining substantial popularity, especially among the young.  Objective: This study aimed to estimate eye risk extent related to CL use among adolescents and understand the association between risk level and CL use patterns and adherence to hygiene and maintenance instructions.  Method: A population-based, cross-sectional study was conducted among adolescents aged 14–19 years residing in the Western region of Saudi Arabia. A structured online questionnaire was used to explore the demographic data, CL use patterns, levels of adherence to safety behaviors in CL use, and experienced eye complaints.  Result: Of 350 participants, 248 (70.9%) used CLs. There was an overwhelming female predominance (93.1%) among users, with occasional, cosmetic, and combined cosmetic-medical uses without prescription or follow-up being the most frequent pattern. Practices in CL hygiene and care were unsatisfactory, with poorer adherence to maintenance instructions. Clinically significant complications (CSC), defined as the presence of at least one of the clinically significant symptoms or any two other symptoms, were reported in 38.7% of CL users (95% CI = 32.6%–45.1%). CSC risk independently increased after 5 years of use (OR = 3.59, 95% CI = 1.51–8.52) and in double-purpose use (OR = 3.34, 95% CI = 1.52–7.37) by reference to cosmetic use only, while adherence levels to CL removal during sleep (OR = 0.21, 95% CI = 0.05–0.92) and not using CLs after the expiration date (OR = 0.28, 95% CI = 0.11–0.73) were protective factors against CSC.  Conclusion: Young Saudi adolescents are highly exposed to unregulated CL use with significant ophthalmological risks. This has several clinical, public health, and policy-making implications.  Keywords: Contact lenses, habits, teenagers, Jeddah, cosmetic, refractive

Contact Lens Use Patterns and Safety Determinants among Adolescents in Western Saudi Arabia