cultivating compliance

Improving Compliance With Lens Replacement Schedules

BY ANNIE CHANG, OD, & TIMOTHY B. EDRINGTON, OD, MS, FAAO

Soft contact lens disposability makes it convenient for patients to wear new lenses on a consistent basis. However, some patients continue to stretch the wear time of each lens. Our challenge is to get patients to follow their prescribed lens replacement schedule, to guard against complications and to offer ways to facilitate improved compliance.

Managing Noncompliance

A careful inspection of patients' superior tarsal conjunctiva for giant papillary conjunctivitis (GPC) can help you determine whether patients need to replace their lenses more frequently, decrease wearing time or modify their care regimen. GPC can be a sign that your patients are over wearing their lenses.

Educate patients to rub their lenses to mechanically remove unbound proteins from the surface. Consider adding an enzyme treatment to the cleaning regimen, particularly for patients who replace their lenses monthly or less frequently.

Consider increasing your prescribing of daily disposable lenses. Don't reserve daily disposables for only your part-time wearers, frequent travelers or water sports enthusiasts. Daily disposables can help combat GPC for patients who are prone to flare-ups, and they're perfect for patients who don't want to hassle with a care system.

One drawback with daily disposable lenses is their limited design availability, particularly in toric options.

Set the Right Schedule

No single lens replacement schedule works best for every patient. Determine the best replacement schedule based on each patient's eye care needs and budget. Some patients require a more frequent replacement schedule because their lens wear comfort decreases over time. Ask your patients if their eyes feel better the first day they wear a new lens. If a new lens seems more comfortable, this may be a sign that lens replacement is not frequent enough. If a patient enjoys the comfort of a new lens, ask how often lenses are discarded. This will allow you to tailor a proper replacement schedule and cleaning regimen for such patients.

For other patients, a monthly lens facilitates better compliance because patients discard their lenses in conjunction with changing the monthly calendar or with each monthly billing cycle.

If patients are ordering lenses from your office, the frequency (or infrequency) with which they place orders can be a good indicator of their replacement schedule compliance. If patients return to your office after more than a year for an annual supply of contact lenses, suspect that they are replacing their lenses less frequently than you prescribed.

Proper Education is Key

Spend time educating patients about their proper lens replacement schedule. Discuss specific benefits of adhering to the schedule and the benefits of a clean, fresh lens. These benefits include better vision, improved comfort and fewer complications (GPC).

Asking the right questions can reveal your patients' lens replacement habits as well as convey the message that proper contact lens disposal is crucial to contact lens enjoyment and success. CLS

Dr. Chang is an instructor at the Southern California College of Optometry. E-mail her at achang@scco.edu. Dr. Edrington is a professor at the Southern California College of Optometry. E-mail him at tedrington@scco.edu.