How to Prescribe For Compliance

Keeping patients comfortable in their contact lenses is easy -- as long as you remember the basics.

How to Prescribe For Compliance
Keeping patients comfortable in their contact lenses is easy -- as long as you remember the basics.
By Laurie L. Sorrenson, O.D., F.A.A.O., Austin, Texas

As eyecare professionals, we take pride in how we communicate with our patients, particularly those we're treating for chronic diseases, such as glaucoma. We make sure they know everything about the medications we prescribe, from dosage to frequency to potential adverse effects. Unfortunately, we sometimes forego this attention to detail when we deal with our contact lens patients. Through informal surveys at my lectures, I've discovered that only 50% of eyecare professionals give their patients a written solution recommendation at their initial contact lens fitting. And almost none discuss solution usage with their patients during annual contact lens examinations, a serious oversight that may affect how patients tolerate their contact lenses.

We need to realize that neglecting proper lens care instruction may prevent our patients from having the best possible contact lens experience. If you want your patients to enjoy comfortable, healthy eyes and longer wearing times, you should make an effort to educate your patients about the importance of proper lens care. Here's how to find out if your patients are cleaning their lenses properly, and what to do if they're not.


The Pitfalls of Private-label Solutions


Patients may be tempted by the low price of private-label solutions, but ...

Private-label solutions can create confusion and interfere with your efforts to diagnose a contact lens-related problem. Because manufacturers aren't required to use the same name for generic and brand-name ingredients, patients and eyecare professionals may be confused over the exact formulation. Differences in labeling can make it difficult to determine what solutions your patient should avoid if he's experiencing adverse effects.

Private-label solutions can change, depending on which vendor manufactures the product.

Educate your patients about the importance of consistent solution usage by prescribing an appropriate care system for their contact lenses.


When patients have contact lens-related problems -- dry eyes, poor vision, irritation -- we often spend a lot of time tweaking the fit, changing the power or even prescribing a new design material, when the culprit is the lens care solution. Many doctors review lens care with patients at the initial contact lens fitting, but few of us review these practices annually. Patients may leave our offices with the erroneous impression that they can use any lens care system with their lenses, only to return with red, irritated eyes. (See "The Pitfalls of Private Label Solutions" for an example.) To avoid similar misunderstandings with your patients, I recommend you take this simple step.

When questioning patients about lens care, I discovered that many were improperly cleaning or disinfecting their lenses. Their excuse: "I was told I could just store my lenses in saline" or "Nobody told me I had to clean my lenses." Yearly solution reevaluations can help prevent communication breakdowns that can result in solution-related problems.

Even if your patients don't complain of contact lens discomfort, it's imperative that you know what lens care products they're using. In our practice, we use the Annual Contact Lens Agreement sheet shown on this page to evaluate patients' lens care habits.

We also take this opportunity to review proper contact lens care, correcting improper solution usage, wearing time and compliance issues. We remind patients what to do if their eyes become red or irritated, and that they must return for annual examinations if they want to continue wearing contact lenses. Finally, we use this agreement as a marketing tool to inform patients about discounts that we offer on back-up eyeglasses and sunglasses when they purchase a 1-year supply of contact lenses.

Our annual contact lens agreement has increased patient contact lens and solution compliance dramatically. We rarely hear comments like "I didn't know I had to use fresh solution each day" or "I was told I could wear my contacts until they became uncomfortable." Now, if patients aren't caring for their lenses properly, it's not because they don't know the proper procedure.


I recommend that every office improve patient communication by instituting an annual, written contact lens care policy for every patient. With such a policy, you can be confident that patients are receiving consistent lens care instruction, even if different technicians talk to them from year to year.

Focusing on the basics of contact lens care can decrease the incidence of solution-related problems.

Dr. Sorrenson specializes in contact lenses at Lakeline Vision in Austin, Texas. She is a part-time faculty member at the University of Houston College of Optometry.