contact lens care
Re-educate Silicone Hydrogel Patients about Lens Care
BY MICHAEL A. WARD, MMSC, FAAO

Silicone hydrogel lenses accounted for 29 percent of new soft lens fits in the first quarter of 2005, compared with 17 percent for the same period last year (Health Products Research, 2005). This representsrepresents a significant increase in use of these materials. Silicone hydrogel materials offer valuable ocular health benefits for lens wearers, but they also require us to refocus on lens care to prevent mechanical and immunologic complications.

Material Differences

The difficulty with "No-rub" multipurpose solution labeling has become increasingly apparent with the expanded use of silicone hydrogel lenses, which are different from HEMA lenses.

Silicone hydrogel materials have lower water content, but higher bound water; they have low levels of total protein uptake, but higher binding of denatured proteins (transfigured proteins that are associated with inflammations such as giant papillary conjunctivitis). Silicone hydrogel lens surfaces have a high affinity for lipid binding. These properties make the silicone hydrogel polymers more likely to attract hand creams, makeup, altered meibomian gland secretions and other environmental debris, which necessitates more attention to keeping the lens surfaces clean.

Don't Just Instruct — Educate

A colleague of mine recently asked, "How do we address the compliance issue now that patients have heard it's okay to not clean their lenses?" Good question. The major factor in patient compliance is patient education; this is the practitioner's responsibility. Educating your patients — not merely instructing them — is the best way to address this issue.

More accurately, this involves re-educating your patients to overcome the multipurpose solution no-rub marketing message. Patient education begins at the very first visit and continues each and every time you have the opportunity to interact with your patients.

Don't Forget to Explain Why

Patients want to be comfortable and have clear vision. They won't knowingly put their comfort or vision at risk. It's important that patients understand why you're instructing them to perform each step of lens care. Instead of simply telling them to rub and rinse their lenses, explain that this procedure removes debris and bacteria that can cause discomfort, poor vision and inflammation, which may limit future contact lens wear. The important message that you want to pass along is that digital rubbing together with proper lens disinfection improves lens comfort, vision and eye health.

Helping Hands

Have you noticed that the words "No Rub" are getting smaller on most multipurpose solution product labels? The major contact lens solution manufacturers may be realizing that the no-rub message isn't appropriate for silicone hydrogel materials. Fortunately, we enjoy a very proactive lens care industry that continues to actively reformulate products for enhanced cleaning and compatibility with these newer contact lens materials.

To obtain references for this article, please visit www.clspectrum.com/references.asp and click on document #120.

Mr. Ward is an instructor in ophthalmology at Emory University School of Medicine and Director, Emory Contact Lens Service.