ON THE SPOT: ANSWERING DIFFICULT QUESTIONS
By PHYLLIS L. RAKOW, COMT, NCLE-AC, FCLSA(H), Princeton, N.J.
How do you deal with patients who question the rules for safe contact lens wear? You know you can't give them permission to bend those rules and risk an adverse reaction.
With this possibility in mind, I've compiled a list of common compliance questions and appropriate answers to help you deal with querying patients.
Q: Why do I have to return for a follow-up visit before I can have my contact lens prescription? I always get my prescription for glasses right away.
A: Initial comfort and improved vision never guarantee that your new contact lenses fit perfectly. Blinking can reseat lens position on the cornea, affecting visual acuity. If you don't produce enough tears, your lenses can dry out and become uncomfortable, a problem that can be fixed by switching to a lens material that holds moisture longer. Once
we're satisfied with your vision, lens fit and comfort, we'll be happy to give you a copy of your prescription.
Q: Why do I need to use the same cleaning solutions all the time? My roommate switched to a store brand, and he's not having any problems.
A: We recommend the contact lens care products that meet your particular contact lens and ocular health needs. Not all solutions are compatible with all contact lenses. Using the wrong solution can deform your contact lenses or irritate your eyes. If you have any problems with the solutions we've recommended, please call our office to find out what other products might be safe for your lenses and for your eyes.
Q: Why do I have to replace my contact lenses after 2 weeks or 1 month when they still feel perfectly good? Why can't I just use them until they wear out?
A: It's important to be proactive about lens care and replace lenses before they cause an infection, ulcers or other potentially dangerous problems. In addition, as the lenses age, the "pores" become clogged with mucus and other debris from your tears, compromising the water content of the lens and leaving you vulnerable to additional problems.
Q: Why can't I sleep while wearing my daily wear lenses?
A: Traditional daily wear lenses don't transmit enough oxygen to keep your eyes healthy during overnight wear. Sleeping in daily wear
lenses can cause your corneas to swell and retain fluid, as well as encourage abnormal blood vessel growth into the clear cornea. This can affect your vision and increase your chances of developing a serious infection or corneal ulcers. If you're interested in sleeping in your lenses, we can ask Dr. Smith if you're a good candidate for an FDA-approved continuous wear lens.
Assert your authority
When answering questions, it's important to remember that you're the contact lens expert: Never let patients cajole you into endorsing lens care shortcuts. Your reputation and your patients' health depend on it.
Contact Lens Spectrum, Issue: October 2004