According to Merriam-Webster’s dictionary, the word prescribe comes from the Latin word praescribere, which means to write at the beginning, dictate, or order. How does this relate to contact lens care solutions? A myriad of contact lens complications can occur due to misusing a recommended care solution or to using a non-prescribed care solution.
All reusable contact lenses require nightly disinfection with a prescribed contact lens care solution. Factors to consider when prescribing a lens care solution are contact lens type and an individual patient’s ocular surface heath. Ocular surface disease, allergies, scarring, and a prior history of contact lens-related inflammatory events may all influence the type of care solution chosen. In addition, if a patient has a solution sensitivity, it may help to recommend a preservative-free option such as a hydrogen peroxide solution. Patients’ lifestyle and prior contact lens compliance, as well as lens surface treatments and care solution ease of use, may also guide care solution choice.
My recommendation is to include the prescribed contact lens care solution on the written contact lens prescription to improve compliance with lens care and to serve as a reference for later use. A suggestion from contact lens experts is to highlight the solution brand on the prescription and to attach a coupon for the proper solution to make it easier to find in stores. Recording this information is helpful at subsequent visits; in addition, if a care solution is recalled, the information can be used to contact and inform patients.
Writing It Isn’t Enough
Communication is key when prescribing lens care solutions. A communication pearl is to start with the reason why a certain solution is prescribed. Explain that there are various lens care solutions on the market, and provide specific reasons why a specific care solution is prescribed for their eye health and needs. Once patients understand the reasoning, they are usually receptive to the recommendation. Explain that compliance with lens care and handling is necessary to keep eyes healthy, happy, and clear in contact lenses, not only for this year but for their entire lifetime of lens wear. Elucidate that if they don’t follow the plan, they may lose the ability to wear contact lenses and risk losing their vision.
Another pearl that cannot be overstated is the importance of images in patient education to ensure compliance. A picture is truly worth a thousand words; it leads to an authentic conversation with patients. I show patients pictures of their contact lenses and their eyes. Additionally, I show them images of the potential negative consequences of improper care of their lenses. The images give patients a buy-in and a heightened understanding of the problem and why to avoid it.
If Patients Still Don’t Comply
I asked experts for advice when patients remain noncompliant. One recommended asking patients what they are and aren’t doing in caring for their lenses, using detailed questions to get to the real story and to understand patients’ perspectives. Practitioners need to figure out why patients do what they do. If they are using a different care system, what is the reason? Is it cost, convenience, or the perception that all lens care products are the same? When a patient admits to not following recommendations, just smile and say “Ahhhh, well, you are human.” It typically breaks the ice and enables a productive conversation on the prescribed solution and on possible alternatives that may be easier for the patient and improve compliance.
Training technicians to discuss care solutions with conviction is another tactic. “The care solution that you are to use is...” helps to reinforce compliance. CLS
The author thanks Mile Brujic, OD; Charlie Clayton, OD; Jennifer Harthan, OD; Chandra Mickles, OD, MS; Christine Sindt, OD; and Jeff Sonsino, OD, for their help with this article.