contact lens care
Silicone Hydrogel Patients about Lens Care
MICHAEL A. WARD, MMSC, FAAO
lenses accounted for 29 percent of new soft lens fits in the first quarter of 2005,
compared with 17 percent for the same period last year (Health Products Research,
2005). This representsrepresents
a significant increase in use of these materials. Silicone hydrogel materials offer
valuable ocular health benefits for lens wearers, but they also require us to refocus
on lens care to prevent mechanical and immunologic complications.
The difficulty with "No-rub" multipurpose solution labeling has
become increasingly apparent with the expanded use of silicone hydrogel lenses,
which are different from HEMA lenses.
Silicone hydrogel materials have lower water content, but
higher bound water; they have low levels of total protein uptake, but higher binding
of denatured proteins (transfigured proteins that are associated with inflammations
such as giant papillary conjunctivitis). Silicone hydrogel lens surfaces have a
high affinity for lipid binding. These properties make the silicone hydrogel polymers
more likely to attract hand creams, makeup, altered meibomian gland secretions and
other environmental debris, which necessitates more attention to keeping the lens
Don't Just Instruct Educate
A colleague of mine recently asked, "How do we address the compliance
issue now that patients have heard it's okay to not clean their lenses?" Good question.
The major factor in patient compliance is patient education; this is the practitioner's
responsibility. Educating your patients not merely instructing them
is the best way to address this issue.
More accurately, this involves re-educating your patients to overcome
the multipurpose solution no-rub marketing message. Patient education begins at
the very first visit and continues each and every time you have the opportunity
to interact with your patients.
Don't Forget to Explain Why
Patients want to be comfortable and have clear vision. They won't
knowingly put their comfort or vision at risk. It's important that patients understand
why you're instructing them to perform each step of lens care. Instead of
simply telling them to rub and rinse their lenses, explain that this procedure removes
debris and bacteria that can cause discomfort, poor vision and inflammation, which
may limit future contact lens wear. The important message that you want to pass
along is that digital rubbing together with proper lens disinfection improves lens
comfort, vision and eye health.
Have you noticed that the words "No Rub" are getting smaller on
most multipurpose solution product labels? The major contact lens solution manufacturers
may be realizing that the no-rub message isn't appropriate for silicone hydrogel
materials. Fortunately, we enjoy a very proactive lens care industry that continues
to actively reformulate products for enhanced cleaning and compatibility with these
newer contact lens materials.
To obtain references for this article, please visit
and click on document #120.
Mr. Ward is an instructor
in ophthalmology at Emory University School of Medicine and Director, Emory Contact
Contact Lens Spectrum, Issue: November 2005