Contact Lens Care & Compliance
Contact Lens Risk Survey Results
BY MICHAEL A. WARD, MMSC, FAAO
A recent publication from the Centers for Disease Control and Prevention (CDC) states that approximately one-third of lens wearers who participated in a national survey reported (ever) going to an eyecare practitioner with complaints of contact lens-related redness and/or pain (Cope et al, 2015). The release of this report coincided with the second annual Contact Lens Health Week, which promotes healthy lens wear. This year’s campaign targeted teenagers and college-aged students, who have in the past been associated with lower contact lens compliance and higher risk for serious eye infections.
In recent years, the CDC has investigated several multistate outbreaks of rare but serious contact lens-associated infections. Research has shown that these infections occurred most often among patients who did not take proper care of their contact lenses and lens storage cases.
The CDC survey was adapted from a soft contact lens risk survey by Wagner et al (2014). Of the approximately 1,000 respondents who completed the Contact Lens Risk Survey, 93% were soft lens wearers, which is in agreement with other demographic market estimates.
Survey respondents were mostly female (82%), more educated, and of white, non-Hispanic race/ethnicity when compared with non-contact lens wearers. GP contact lens wearers did not differ significantly in age from non-contact lens wearers, although wearers of soft, daily disposable, and overnight contact lenses were significantly younger.
Nearly all (99%) survey participants reported at least one risky behavior relative to contact lens wear and care practices. The most commonly reported risky behaviors were napping in contact lenses (87.1%); showering in contact lenses (84.9%); and using lens storage cases longer than the recommended length of time before replacement (82.3%). Other survey results indicated that 50% of respondents extended the recommended lens replacement frequency, and 61% reported swimming while wearing contact lenses. About 91% of GP lens wearers reported using a water rinse, and one-third reported storing their lenses in water.
A separate report estimates that there are 40.9 million contact lens wearers over 18 years old in the United States, which is higher than previously reported; this represents 16.7% of U.S. adults (Porter Novelli, 2014; U.S. Census Bureau, 2014).
This report serves to remind us all of the risks of patients’ non-compliance and practitioners’ lack of proper instructions when associated with contact lens wear and care. Contact lens wear remains the number one risk factor for microbial keratitis (MK). And, the risk of contact lens-associated MK increases significantly with continuous wear and when wearing lenses during water activities (e.g., swimming and/or showering) (Franks et al, 1988; Stehr-Green et al, 1989; Dart et al, 1991). It is apparent that water and soft contact lenses do not mix. The jury is still out regarding the risk of MK among GP lens wearers using water to rinse lens cleaners from contact lenses prior to disinfection.
Risks for MK can be mitigated through education and proper patient instruction. The CDC recommends: “Prevention efforts could include vigorous health promotion activities that encourage contact lens wearers to improve their hygiene behaviors, such as keeping all water away from contact lenses, discarding used disinfecting solution from the case and cleaning with fresh solution each day, and replacing their contact lens case every [three] months” (CDC, 2015).
For more suggestions, see my list of patient Dos and Don’ts in my column in the June 2015 issue of Contact Lens Spectrum. CLS
For references, please visit www.clspectrum.com/references and click on document #239.
Mr. Ward is an instructor in ophthalmology at Emory University School of Medicine and director, Emory Contact Lens Service. You can reach him at firstname.lastname@example.org.