Article Date: 11/1/2012

Contact Lens Care & Compliance
Contact Lens Care & Compliance

Written Educational Materials Improve Lens Compliance

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BY SUSAN J. GROMACKI, OD, MS, FAAO

A recent paper reported that the most significant risk factor for contracting Acanthamoeba keratitis is poor contact lens hygiene (Yoder et al, 2012). Few would dispute the importance of proper contact lens care and replacement. The challenge comes in how to properly educate our patients to be compliant.

A Useful Instruction Manual

Some of our noncompliant patients are the ones we least expect. They are noncompliant without even knowing it. In his textbook Clinical Manual of Contact Lenses, Dr. Ed Bennett recommends that the contact lens education process include: 1) written information, 2) verbal information, 3) video instruction, and 4) reinforcement at future visits (Bennett, 2000). While I have not always relied on video instruction, I have always found it beneficial to provide a handout to reinforce patients’ verbal contact lens education. This is important in our increasingly paperless society, as an invitation to “find it on the internet,” is often met with willing ears but no action.

TABLE 1 Patient Lens Care Instruction Manual Items
1. Application, removal, and recentering
2. Care system prescribed and no substitutions
3. Cleaning instructions
4. Wearing schedule
5. Normal adaptation symptoms
6. Abnormal symptoms, including:
Eye pain
Light sensitivity
Redness
Excessive tearing or discharge
Blurry vision
7. 24-hour phone number to call
8. Visit schedule
9. Contraindications to swimming/showering in lenses
10. Benefits of an up-to-date pair of eyeglasses
11. Lens case care and replacement

This document may be part of or in addition to a contact lens fitting agreement, contact lens service agreement, and informed consent document. What should you include in these forms? To answer this question, I asked some of optometry’s leading contact lens practitioners to share their patient instruction materials with me. Table 1 lists what topics these forms typically include.

To maximize the benefit of these documents, they should be written in a vernacular that the patient will understand. The print should be of high quality to make it comfortable and appealing to read (Bennett, 2000). Retain one copy of this form in the patient’s record and give the other copy to the patient.

Understand that although many patients will choose not to review the document at home, the best results are achieved when you instruct all patients to do so.

Reinforce Compliance

In summary, good verbal patient instruction regarding contact lenses—whether performed by the practitioner, technician, front desk staff member, or all three—should be supplemented with a detailed educational handout for patients to take home. Some learn better via the written word; others benefit from the reinforcement that these handouts provide.

Whatever the case, providing reinforcement to increase compliance with our lens care instructions is an endeavor that pays great dividends in practice. CLS

The author would like to thank Drs. Doug Benoit, Clarke Newman, and Susan Resnick for their contributions to this article.

For references, please visit www.clspectrum.com/references.asp and click on document #204.

Dr. Gromacki is a diplomate in the American Academy of Optometry’s Section on Cornea, Contact Lenses and Refractive Technologies and practices in Chevy Chase, Md.


Contact Lens Spectrum, Volume: 27 , Issue: November 2012, page(s): 17