Contact Lens Practice Pearls

Education is Key to Improving Lens Replacement Compliance

Contact Lens Practice Pearls

Education is Key to Improving Lens Replacement Compliance

By Gregory J. Nixon, OD, FAAO

We know how important compliance is to maintaining successful lens wear and preventing contact lens-related complications. For that reason, I've been dismayed by recent studies that report substantial noncompliance rates. One study reported that compliance with recommended replacement schedules measured as low as 48 percent (Dumbleton, 2009).

It is often speculated that patients knowingly stretch their lenses to save money or because they perceive them as safe to wear for longer than recommended. However, this study stated that the primary reason for lens replacement noncompliance was simply because they forgot when to replace them. Additionally, Dumbleton reported a significant improvement in replacement compliance for patients whose practitioners invested more time to educate them on lens replacement during the exam.

While noncompliance rates from this study are discouraging, I am actually encouraged by the fact that educated patients exhibit better compliance behaviors. Thus, we as practitioners carry a degree of responsibility to improve our communication to patients on all aspects of proper contact lens wear and care.

Lens Replacement Compliance

Dumbleton reported that 51 percent of noncompliant patients cite forgetfulness as the overwhelming reason for their lens replacement behavior. Thus, it seems a simple reminder on when to replace lenses is effective to improve timely replacement.

With technology playing a dominant role in most contact lens wearers' lives, I recommend utilizing cell phone reminder functions to alert lens replacement times. While patients are still in the exam room, I instruct them to take out their phone and input a recurring reminder on the first of the month for monthly replacement contact lenses and the first and 15th of the month for two-week replacement lenses.

Contact Lens Care Instructions

Similar to lens replacement behavior, I have found that patients' lack of lens care compliance is also related to either forgetfulness or to lack of awareness of proper care rather than to a conscious cost-cutting measure. Therefore, my practice has recently employed a comprehensive contact lens care review at all annual contact lens exams. This includes disseminating both verbal and written instructions on:

• Washing hands prior to handling lenses.
• Proper rubbing and rinsing of lenses.
• Using fresh disinfecting solution each night.
• Air drying cases with the lids off during the daytime.
• Proper wearing time and lens replacement.
• Proper contact lens case care and replacement.

Take the Time to Educate

Since employing the new education program above, I have discovered that nearly half of our patients comment that they were not fully aware of some aspect of the care instructions we reviewed. Like the Dumbleton study, the feedback from our patients suggests that lack of proper awareness appears to be a significant issue. Therefore, I encourage all of you to invest the time to educate your patients and take the responsibility to be part of the solution to improving patient compliance. By educating patients at each exam and providing written take-home instructions, we can significantly impact successful lens wear and care. CLS

For references, please visit and click on document #201.

Dr. Nixon is an associate professor of clinical optometry and director of extern programs at The Ohio University College of Optometry. He is also in a group private practice in Westerville, Ohio. He is on the Allergan Academic Advisory Board, the B+L Advisory Board, and the Alcon Speakers Bureau. You can reach him at