Contact Lens Care & Compliance
Ocular Comfort’s Relationship with Multipurpose Solutions
BY ANDREW D. PUCKER, OD, PHD, FAAO
Multipurpose solutions play a critical role in maintaining daily wear contact lenses: they clean, disinfect, and allow for safe short-term storage of contact lenses (Rosenthal et al, 2003). Contact lens discomfort is likely one problem that your patients face on a regular basis (Nichols et al, 2013).
While contact lens discomfort has a number of etiologies, a variety of factors related to multipurpose solutions could have a major impact on comfort and contact lens satisfaction (Jones et al, 2013). This is highlighted by the fact that multipurpose care system choices can affect blink rate, which is likely a surrogate for ocular irritation; fewer blinks have been associated with better comfort (Yang et al, 2012).
Multipurpose solution components can have an impact on ocular comfort. Specifically, wetting agents have been added to multipurpose solutions to improve contact lens comfort (Stiegemeier et al, 2006; Yang et al, 2012). Stiegemeier et al (2006) found that solutions with wetting agents improved corneal staining, dryness, scratchiness, burning, wear time, and deposits compared to solutions without wetting agents. Similarly, Yang et al (2012) found that solutions with wetting agents can result in fewer dry eye symptoms compared to solutions without wetting agents.
Solution preservatives may also impact ocular comfort (Jones et al, 1997). Jones et al (1997) also determined that solutions with higher preservative concentrations may result in lower contact lens comfort and overall solution satisfaction compared to solutions with lower levels of preservatives. This last point highlights how similar yet slightly different solutions can impact patient satisfaction, a point that should be acknowledged when store brand solutions are considered.
Contact lens/solution combinations can impact ocular comfort (Stiegemeier et al, 2004; Tilia et al, 2013), yet Tilia et al found that those combinations typically only lead to comfort issues in patients who have a history of contact lens discomfort.
Lin et al (2014) reported that ethnicity and potentially cultural issues may affect a patient’s compatibility with a care system. For example, they found that Caucasians were more likely to report good lens and solution comfort at lens application, during the day, and at the end of the day compared to Asians.
The above contact lens care solution and patient factors, among others, in combination with proper contact lens care and use, can improve ocular comfort and patient satisfaction (Jones et al, 2012; Pinto-Fraga et al, 2016). Considering these factors may help you fit those difficult patients with contact lenses or re-establish someone as a contact lens wearer. CLS
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Dr. Pucker earned his OD, MS, and PhD degrees from The Ohio State University. He is currently a senior research associate at The Ohio State University. He has also received research funding from Johnson & Johnson Vision Care. You can reach him at email@example.com.