Article Date: 6/1/2001

contact lens case reports

The Cost of Solution-induced Dry Eyes

BY PATRICK J. CAROLINE, FAAO, FCLSA, & MARK P. ANDRÉ, FAAO, FCLSA
June 2001

Patient K.M. is a 32-year-old female salesclerk with a 12-year history of soft contact lens wear. For the past six years, she has been wearing monthly replacement lenses with nightly disinfection in a multipurpose lens care solution.  Upon initial presentation, the patient complained of dry eyes resulting in a gradual decrease in wearing time. Her previous eyecare professional told her that she had dry eyes and recommended that she use a preservative-free, unit-dosed artificial tear three to four times a day to manage her symptoms.

Figure 1. Multipurpose soft lens disinfection systems.

A detailed slit lamp examination revealed that both eyes were within normal limits and free of any ocular findings consistent with a decrease in lacrimation. After our preliminary diagnosis of solution-induced dry eyes, we began our routine management plan which consists of daily disposable soft lens wear for seven days.

After one week, her dry eye symptoms dramatically improved and she wanted to pursue daily disposable lenses. We discussed the fact that the new daily disposable modality would cost more (approximately $400 per year) than her current one-month planned frequent replacement lenses and solutions (approximately $230). She made some quick calculations in her head and concluded that it would be less expensive for her to use daily disposable lenses:

While it is true that many patients can get multiple doses of the drops from a single ampoule, our patient found this practice inconvenient because the tops of the PF "reusable" containers frequently leaked into her pockets or handbag.

The patient happily chose to continue with the daily disposable lenses because of the increased comfort, secondary to the elimination of her dry eye symptoms. This resulted in a financial saving of approximately $200 per year.

The cost of unit-dosed preservative-free artificial tears is a factor practitioners frequently overlook. Thanks to this patient, we better understand the added expense in treating the dry eye symptoms associated with multipurpose solution sensitivities.

 

TABLE  1:  Preservative Free Artificial Tears   

BRAND   

UNITS   
PER BOX   

RETAIL  
PRICE   

PER UNIT
PRICE

Thera Tears   

32   

$11.99   

$0.37

Bion Tears   

28   

$13.69   

$0.49

Tear Naturale   

36   

$9.97   

$0.28

Refresh   

30   

$10.89   

$0.36

Refresh Contacts   

20   

$6.49   

$0.32

Refresh Plus   

30   

$9.99   

$0.33

Lens Plus   

30   

$7.49   

$0.25

ReNu Tears   

20   

$6.79   

$0.34

Hypotears PF   

30   

$11.99   

$0.40

The average cost per ampoule of preservative-free artificial tears is $0.35. Yearly cost for usage:   

Twice a day   

 = $255.50 per year   

Three times a day   

 = $383.25 per year   

Four times a day   

 = $511.00 per year   

Patrick Caroline is an associate professor of optometry at Pacific University and an assistant professor of ophthalmology at the Oregon Health Sciences University. Mark André is director of contact lens services at the Oregon Health Sciences University.


Contact Lens Spectrum, Issue: June 2001