Contact Lens Practice Pearls

Compliance: Make it a Focus

BY JASON MILLER, OD, MBA, FAAO

Disposable soft contact lenses have grown rapidly since their inception—and so has the noncompliant behavior associated with them. There are many reasons for this, including the commoditization of contact lenses, some passivity from eyecare practitioners with regard to contact lens replacement schedules, and patients listening to the wrong people.

Compliance is an important contributing factor for successful contact lens wear and a successful contact lens practice. All products have guidelines for healthy, successful use, and noncompliance can have a severely detrimental effect on patients’ eye health, comfortable contact lens wear, and thus the profitability of an eyecare practice.

Modality Choices, Strategies

Modality of wear is an important topic to address, as patients not complying with their wear schedule will often times have comfort issues that affect their contact lens wearing experience. They often present with the report of changing their contact lenses when the lenses “feel bad.” The key to improving compliance is to listen to your patients and understand what they are looking for with their contact lens wear. Individualizing your contact lens prescribing habits to best meet your patients’ lifestyles will maximize compliance and contact lens success.

For example, someone who wears glasses most of the time but prefers to wear contact lenses when he plays hockey three times a week would be poorly served by being fit with a pair of two-week or monthly replacement lenses, and would most likely be an ideal candidate for a daily disposable contact lens. The irregularity of this patient’s wearing schedule would make it difficult to keep track of the age of the lenses and would unintentionally force noncompliance.

Improving Comfort

Complying with a prescribed contact lens replacement schedules is important for health reasons, but also to maximize comfort. We all have seen patients who have a significant number of deposits on their contact lenses that can be directly related to “stretching out” their wearing schedules. If we can eliminate these bad habits, we will increase our patients’ chances of comfortable, healthy contact lens wear.

Don’t Forget Care Systems

Just as important as the contact lens replacement schedule is the care and cleaning of contact lenses. The unfortunate reality is that there is significant room for increasing compliance levels with our patients. It is important for those who utilize lens care systems to be constantly re-educated on the specifics of their contact lens care regimen. For troubleshooting, consider asking patients to describe the way in which they care for their contact lenses in a step-by-step manner and then re-educate them on those steps that they are performing incorrectly.

Noncompliance with contact lens care is a common problem. It has been reported that greater than 44 percent of patients always or occasionally top off or reuse their contact lens solution (Stone, 2007). Additionally, 35 percent of patients do not wash their hands before lens handling, and only 25 percent of patients report rinsing their contact lenses before storage (Stone, 2007).

Encourage Compliance Daily

In summary, don’t lose sight of compliance when looking at your next contact lens patient. Encourage all of your patients to comply with proper contact lens wearing behavior and consider refitting with a different lens modality when it will minimize the risk and maximize success with contact lens wear. CLS

For references, please visit www.clspectrum.com/references.asp and click on document #208.

Dr. Miller is in a partnership private practice in Powell, Ohio, and is an adjunct faculty member for The Ohio State University College of Optometry. He has received honoraria for writing, speaking, acting in an advisory capacity, or research from Alcon, Allergan, CooperVision, and Visioneering Technologies. You can reach him at drmiller@eyecarepowell.com.