Contact Lens Care
It's All About Compliance by the Prescriber
Joseph Barr, OD, FAAO
We have the greatest soft contact lenses ever.
Hypoxic contact lens complications are becoming obsolete. And our lens care systems
are better than ever, too. But if the prescriber and the provider don't insure that
the patient is pristinely healthy and don't continually educate the patient about
proper use of these great new products, then we will continue to have contact lens-related
complications and contact lens dropouts.
Realize that the FDA approves a lens
care system as if it would be used with complete compliance. But we know lens care
compliance is very poor.
I have three messages.
1. Prescribe the lens care system strongly.
Make a firm recommendation about what each patient should use. Make sure the patient
knows what product you want him to use and that he should never change the lens
care system without your approval. This assumes, of course, that you are up-to-date
on all the latest information on contact lens care. If not, then you can learn more
at www.CLSpectrum.com or subscribe to www.CLToday.com.
2. Educate, educate, educate to get
compliance, compliance, compliance. Contact lens patients are notoriously noncompliant.
So tell them why they should rub, rinse and soak their lenses after each removal
in totally fresh solution in a clean case. Tell them why they should not top off
the solution in their case. Tell them to replace their case regularly, and re-educate
them at each visit that if they do these steps, they can have a longer, healthier,
better-vision, contact lens-wearing lifetime. If you care about their compliance
and their safety, bond with them and make them believe this education is important
to their success.
3. Do a slit lamp exam with fluorescein.
Yes, for soft contact lens wearers. It doesn't take long; the patient will be impressed
with you, and, in fact, you may even detect something that could be important. Sure,
most patients don't have clinically significant staining, but if they do, it could
be important. Recent studies indicate that future corneal infiltrative events, although
rare, may be associated with previous reports of corneal staining.
Fortunately, the eye's immune system
protects our patients every day from a lens that they have infected, despite the
fact that the lens care system should have been protective. Don't assume that their
state-of-the-art lenses and lens care system will protect them when you know they
will be noncompliant.
In summary, make sure you know what
you and your staff want to recommend for lens care and recommend it strongly. Educate
your patients repeatedly to comply with proper lens care (clean, rinse, soak in
totally new solution, in a clean case) and use fluorescein to examine the cornea
for potential compromise.
Contact Lens Spectrum, Issue: August 2006