No matter how diligently we educate patients about proper lens care and compliance, our sphere of influence is limited to the office. A rare few will take our lessons to heart, but an overwhelming majority of patients inevitably take lens care shortcuts -- often with disastrous results.

Since following every patient home to monitor their lens care regimen isn't an option, we need to underscore the importance of developing and continuing good lens care habits before patients leave the office. Here's an approach I like to call "good cop versus bad cop."

Gentle persuasion

New patients may be excited -- and a little nervous -- about their contact lenses. Some worry about applying and removing their lenses, whereas others are concerned that cleaning and caring for their lenses will be complicated and time-consuming. As contact lens technicians, our job is to reassure patients that contact lenses can be very rewarding -- if they follow directions.

Initial instruction is very important. Spending extra time coaching patients in contact lens application and removal is a good investment in their future eye health. Let patients practice with their lenses until they're comfortable.

The longer patients successfully wear contact lenses, the more likely they are to become complacent about hygiene. Most patients can use no-rub multipurpose solutions without difficulty, so you should encourage them to follow the manufacturer's directions for keeping their lenses clean. I often recommend that patients rub their lenses for just a few seconds to ensure they're really clean, but most solutions work effectively without this extra step.

Positive reinforcement supported by detailed written directions is usually the best approach to ensuring lens care compliance, but sometimes patients need to be reminded of what could go wrong if they ignore your advice. In these situations, I tend to take on the role of the "bad cop."

Scared straight

Scheduled follow-up exams are an ideal opportunity for us to observe our patients' lens care habits. Do they wash their hands before handling their lenses? Are their fingernails dirty or too long? If they bring a case, is it clean or is it slimy? Always ask them to demonstrate how they clean their lenses, using your observations to reinforce good habits and correct bad ones. When I encounter an especially noncompliant patient, I use graphic visual aids to show him the potential consequences of his poor lens care habits.

Showing patients vivid pictures of conditions caused by improper lens care is an effective, if somewhat dramatic, attention-getting strategy. An especially nasty picture of 4+ giant papillary conjunctivitis illustrates the consequences of neglecting proper lens hygiene, just as a spidery photo of an extensively neovascularized cornea brings home the dangers of contact lens noncompliance. Once patients become aware of the severe consequences they risk with contact lens abuse, they may be more motivated to adhere to a healthier lens care regimen.

Smart investing

As contact lens technicians, we're responsible for setting patients on the path to success. As daunting as this may seem, you'll find that a modest investment of time, patience and attention to detail can yield surprisingly high returns.