Contact Lens Practice Pearls

Patient Education Is More Than Do's and Don'ts

By John Mark Jackson, OD, MS, FAAO

It's patient noncompliance month in Memphis! I recently found myself in a few situations that gave me some interesting insight into patient education about lens wear and care.

What You Don't Know...

This week I had a bit of a disagreement with the cable guy. While installing my new TV system, he asked my line of work. When I told him I'm an eye doctor, he said, laughing a little, “I probably shouldn't tell you this, but I never take my contacts out.” Never? He swore he was given extended wear contact lenses, but he took it literally and had not taken them out for seven or eight months.

My usual line in response to this is, “You seem to have the mistaken idea that someone is going to give you a spare eyeball when you lose one to an eye infection.”

He was unimpressed. “I can get around with only one eye.” Really? He mentioned he had a young son and I told him it would be hard to play ball with him with no depth perception. That seemed to get his attention.

But the bottom line is that he seemed to have no idea of the consequences of over-wearing his lenses like this. I showed him some pictures on my iPhone of microbial keratitis and tried to get him to understand why he should do things the right way.

This week I saw a young lady in clinic who developed a corneal ulcer (Figure 1) from wearing opaque contact lenses illegally sold by a beauty supply store. She wore them on an extended wear basis for months at a time, “until they would crack.”

Figure 1. Microbial keratitis from “beauty shop” contact lens purchase.

The consequence of her lack of education about proper lens wear and care was a shock to her. We treated her ulcer and gave her education on the right way to do things and on the need for professional fitting and follow-up care. She seemed to get the idea now…we can only hope.

Now for my own confession about noncompliance. My mother recently broke her ankle and required surgery. In recovery, a respiratory therapist came in, announced that she should breathe into an inspirometer every 15 minutes, and walked out without saying another word. We were rather focused on her coming out of anesthesia and her pain and didn't give much thought to the breathing apparatus. A different therapist later was very upset that we weren't using it, and gave us the reasons why she needed to do it—to prevent pneumonia and keep her passages open. We used it diligently after that.

Conveying all the Information

The common thread here is lack of quality patient education. Perhaps we too often view patient education about contact lenses as simply a list of do's and don'ts. Salesmen are taught that “features tell, benefits sell,” meaning you have to make customers understand why a feature is important to them. We know the benefits of proper lens care and risks for noncompliance, but if we and our staff members aren't conveying these well to patients, we can hardly expect them to follow our instructions. Patients will still do crazy things, but maybe we can convince a few more of them to respect their eyes. CLS

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Dr. Jackson is an associate professor at Southern College of Optometry where he works in the Advanced Contact Lens Service, teaches courses in contact lenses, and performs clinical research. You can reach him at jjackson@sco.edu.