contact lens care
No Rub Read the Fine Print
BY SUSAN J. GROMACKI, OD, MS, FAAO
In the past year, the FDA has approved this indication for all of the leading brands of multi-purpose solutions: SOLO-care (CIBA Vision), ReNu (Bausch & Lomb), Complete (Allergan), and Opti-Free Express (Alcon). Obviously, these solutions have passed the FDA's rigorous testing for microorganisms. All of these solutions work well if patients follow the care regimen on the package insert. But what if they don't? I've found that patients who, predictably, allege that their previous practitioner did not inform them of this are not always reading the fine print. Noncompliance, always an issue with care regimens, is still a factor in what has become the simplest regimen ever. And this is leaving practitioners to treat complications such as conjunctivitis, phlectenulosis, dry eye, allergic reactions and keratitis.
The problem is, many patients read "No Rub" on the packaging and bottle and assume this means to remove their lenses and place them directly into the solution-filled case. However, none of these solutions have been approved for that.
What does the fine print say? The following messages are from package inserts or inside the solution's packaging box.
"Rinse each side of the lens for 5 seconds...Prior to reapplying lenses, rinse each side of the lens for 5 seconds with fresh solution...Your doctor may recommend additional care procedures. This may be particularly important if lenses are kept longer than 90 days...Place 3 drops or more of solution on each lens surface and gently rub for at least 10 seconds."
"Thoroughly rinse each side of the lens for 5 seconds...Before wear, rinse each side of the lens for 5 seconds...Your eye care professional may recommend additional products...or procedures to care for your lenses (such as rubbing...)"
"For lenses replaced in 30 days or less...Thoroughly rinse each side of the lens (5 seconds)...If your eye care professional recommends an additional rubbing step, follow the procedures described below...for lenses replaced greater than 30 days...Place at least three drops of ReNu MultiPlus Solution on each side of the contact lens and rub for 20 seconds...Remove surface debris by rinsing thoroughly with ReNu MultiPlus Solution."
"(For lenses replaced in 30 days or less.) Thoroughly rinse each side of the lens with Solo-care Plus...Your eye care professional may recommend additional products...or procedures (such as rubbing). (For lenses replaced after 30 days, or at your eye care professional's request.) Apply at least 3 drops of Solo-care Plus on each side of the lens and gently rub the lens 10 seconds per side. Rinse the lens thoroughly with Solo-care Plus."
It is our job as practitioners to ensure proper patient compliance. At every visit, ask your contact lens-wearing patients to explain in detail how they care for their lenses. If they are not complying, correct them, or else they may return to your office with a complication. This will save you chair time, and result in happy patients and practitioners.
Dr. Gromacki has a specialty contact lens practice as part of a multi-subspecialty ophthalmology group in Fishkill, NY, and has served as a faculty member at the University of Michigan Department of Ophthalmology and Visual Sciences.