Going the Distance
BY MARY JAMESON, BHS, CPOT, COA, NCLC, Elkins Park,
Have you uncovered end-of-day comfort issues among your patients? You can help these patients by investigating whether their discomfort is caused by their contact lenses, their lens care system, eye disease, the environment or a combination thereof. Here are some strategies for isolating and treating end-of-day discomfort.
Is it the lens?
Previously successful contact lens wearers who suddenly develop problems, such as redness or irritation, may be reacting to defective lenses. If the discomfort is bilateral, it's fairly simple to test this theory. Just ask the patient to remove his lenses. If his symptoms improve, you can assume the lenses are at fault. If the patient is experiencing problems in one eye only, have him remove the troublesome lens and reapply it to the other eye. If his symptoms travel with the lens, it's probably defective.
Other contact lens-related problems that can limit wearing time include:
- Improper fit (lenses too tight or too loose)
- Protein buildup.
Lens-related end-of-day discomfort is relatively easy to address by replacing defective lenses or refitting patients with a different modality. If patients continue to complain of discomfort, however, you'll need to consider other possible causes.
Is it the lens care system?
Regular care and cleaning should remove protein buildup that can cause end-of-day contact lens discomfort, but sometimes the lens care system itself is the source of the problem. Patients can become sensitive to specific preservatives in lens solutions, resulting in red, itchy, burning eyes. Changing to a different preservative system may be the answer. Patients who are prone to unusually heavy protein buildup may find relief by switching to disposable or GP lenses.
Is it the eye?
Dry eye disease or abnormal tear production can affect contact lens comfort significantly. Other factors that can affect the eye include environmental irritants, such as poor air quality, pollen or other allergens. Patients can extend wearing time by treating the cause of their dry eye problem, or by avoiding situations and environments that can contribute to end-of-day discomfort.
Staying on course
Don't let your patients abandon their contact lenses. End-of-day comfort issues are easy to fix with lens replacement, the appropriate care system or medical treatment. With a little effort, your patients can get the most out of their contact lenses.
Contact Lens Spectrum, Issue: February 2004