Keep Reinforcing GP Lens Compliance
BY JOHN MARK JACKSON, OD, MS, FAAO
Some of my favorite things about GP lenses are their durability and deposit resistance. However, we should not let the inherent deposit resistance of GP materials decrease our continued patient education on the need for proper lens care. A recent case reminded me of this very important point.
My patient was a 10-year-old boy who began wearing orthokeratology lenses about six months ago. He was doing well with the treatment at his two-month progress exam, and both he and his parents were very satisfied. As I usually do, I made sure to reinforce proper lens care including always rubbing the lenses to clean them, rinsing thoroughly, and storing in fresh solution. I asked them to return at six months.
I got a call from the patient’s mother just prior to this time, stating that his eyes had been red and irritated right after removing the lenses in the morning for the past week or so. The irritation mostly went away after about 30 minutes each day, but it seemed to be getting worse. They came in for a progress exam the next day.
As you can probably predict, his lenses were heavily deposited (Figure 1). We were able to clean the lenses well with Progent (Menicon) and remove almost all of the deposits (Figure 2). He also had significant contact lens papillary conjunctivitis (CLPC; similar to Figure 3) and mild central corneal punctate staining.
Figure 1. Heavy protein deposits on an ortho-k lens.
Figure 2. Clean lens after a Progent treatment.
Figure 3. Contact lens papillary conjunctivitis (on a different patient).
COURTESY OF GREGORY W. DENAEYER, OD, FAAO
We questioned the patient on his lens care habits; of course, he had stopped rubbing his lenses shortly after our last progress exam. This was a surprise to his parents. We had a lengthy discussion about the lens deposits causing the lid and corneal issues, and I re-educated the family on proper lens care (and the need for parental monitoring). We also decided to add Progent to the regimen on a monthly basis.
We discontinued lens wear for a few weeks and used a topical steroid to reduce the CLPC. His lids cleared up nicely, and he was able to resume ortho-k treatment. Having to stop wearing the lenses made him realize how much he liked the treatment, so hopefully he will be more compliant with lens care from now on.
No matter what type of lenses a patient uses, proper lens care, and lens care education, must remain at the heart of our contact lens patient encounters. CLS
Dr. Jackson is an associate professor at Southern College of Optometry, where he works in the Advanced Contact Lens Service, teaches courses in contact lenses, and performs clinical research. You can reach him at firstname.lastname@example.org.