editor's perspective
Dropouts, the Eye and Education

Here's what we know: The United States has two contact lens wearers for every one contact lens dropout. That's both good news and bad news. If you like numbers, that's 35 million contact lens wearers in the United States and 17.5 million have-beens. So what can you do about it — or do you care? You could just say, "some patient's eyes just don't accept contact lenses." Or you could say, "I'll happily fit any of those 17.5 million dropouts because they're willing to apply something on their eyes." Or you could say (this is the 60s version), "Practitioners just don't know how to fit some patients." Don't make me laugh.

Here's another statistic: 22 percent of current contact lens wearers have worn the same lens type for 10 years. Are these patients the survivors, meaning they can wear Coke-bottle bottoms, or are they the patients about to drop out unless you rush to their aid?

Do you care whether patients who haven't come in to your practice for years need something different? A few years ago, we called such patients and asked them why they had stopped coming to see us. To our amazement, most of them scheduled an appointment.

Here's the point. Sure, most dropouts quit wearing contact lenses for comfort reasons and so-called drying. And in today's world, with better lenses that dehydrate less and better solutions that add moisture, it's not hard to make things better.

Do you really update each patient to the best material for his eyes and the solution you think is best, or do you let someone else make those decisions? Do you explain everyday lens care or let someone else instruct your patients?

I believe most practitioners care little about drop out. They have delusions that more patients will want contact lenses than will drop out, and obviously, they're right. And most think that contact lens dropouts just can't tolerate the lenses and really aren't worth that much to the practice — which isn't true.

So what can you do to minimize drop out and make your contact lens wearers comfortable and happy? Prescribe the most comfortable, biocompatible lenses and explain why you do. Prescribe the most biocompatible solutions and educate your patients over and over again about how to use them properly. Educate patients about why lens disposing compliance is important. Explain whether patients can or can't sleep while wearing their lenses, and if they can, then explain when and when not to. Review all of this at every visit. Recall, communicate, update, educate and review proper lens care and compliance over and over again.