Reader and Industry Forum

Give Patients the Opportunity to Experience Daily Disposables

BY CHUCK ALDRIDGE, OD, MBA, FAAO

Henry Ford once remarked, “Any customer can have a car painted any colour that he wants so long as it is black,” (Ford, 1909). There has been speculation about the intent behind his remark, but without a doubt, he did not want to have something like color distracting from his prized Model T automobile.

I feel the same way about daily disposable contact lenses. We have now reached a point in contact lens technology at which almost all prescriptions are available as a daily disposable. Spheres, most torics, and even many multifocal prescriptions are now offered in the daily disposable modality. We find this technological advancement so important in our practice that, to paraphrase Henry Ford, we inform our new contact lens patients: “You can have any contact lens you want as long as it is a daily disposable.”

I don’t mean for this statement to sound harsh—as if we don’t care what our patients want. But to be fair, let’s ask the simple question: How can patients who have never before worn contact lenses truly understand what modality is best for them? Patients know they want to try contact lenses, and they may think that they want overnight wear—but having never worn contact lenses before, how can they be sure?

An argument that I hear from some practitioners is: “While I feel that daily disposables are best for my patients, they just don’t want to pay the higher price.” And the sad truth is that, in many cases, it is the protocol that these practitioners use—rather than the price—that turns patients away from daily disposable lenses. Many practitioners never provide a daily disposable lens trial to patients so that they can understand the “value” of the modality. Instead, what patients typically hear is: “These are the contact lenses that we offer and what they cost. Which do you want?”

Lessons About Value

I remember a time when most homes had telephones in them. If you weren’t at home and needed to make a call, you used one of the seemingly ubiquitous phone booths. Today, nearly everyone has a cell phone, and phone booths have all but disappeared.

What led to this transition? It was the experience of the new technology. Early adopters showed off their cell phones to friends, family, and colleagues, giving them a first-hand chance to witness and want the benefits of the new technology.

What’s interesting is that cell phone technology costs more than having a basic phone at home, but the masses have found “value” in this technology and are willing to pay more for it. Furthermore, most of these cell phone owners have now experienced the “smartphone” and are willing to pay even more for one, because they understand the “value” in this technology as well.

Our new contact lens patients could get some understanding of the different lens modalities from what their friends and family tell them. But with contact lenses, they cannot have the “experience” until they try it for themselves. Only then can they understand the “value” of daily disposable contact lenses.

Not only are new contact lens patients seeking the experience of being free from eyeglasses, they are depending on us to direct them to the best contact lens option to achieve this. A recent study of astigmatic patients showed that the majority (91%) are willing to trial a daily disposable contact lens for astigmatism with a practitioner’s recommendation (American Public Health Association, 2013). Data from another survey reveal that practitioners more often select a daily disposable contact lens for astigmatism for health reasons, while patients choose it for convenience (Morgan et al, 2014).

Practitioner Opinions of Daily Disposables

I have attended numerous eyecare meetings over the last decade at which attendees were polled as to what contact lens modality they thought was best. I’ve found it very interesting that nearly all of those voting felt that daily disposables were the safest and best modality of contact lens available. Additionally, when asked what contact lens modality was being worn by the practitioners, the vast majority often indicated that they wore daily disposables. Isn’t it intriguing that we feel that the daily disposable modality is best, it’s what we use ourselves, but we don’t strongly recommend it?

This is not to say that practitioners aren’t making improvements in prescribing daily disposable contact lenses. A recent study showed that 30% of contact lens fits in the United States were with daily disposable lenses, which is significantly up from 5% in 2002 and 10% in 2007 (Morgan et al, 2014). But this figure still lags behind those of many other parts of the world, and definitely lags behind what we as practitioners say that we believe is best.

Reduce Compliance Problems

Lack of compliance is a huge hurdle that we all deal with in our contact lens patients. Overnight contact lens patients who purchases a six-month supply only once a year happens much more often than we like. Before I moved more of my patients into daily disposables, I was spending a lot of chair time preaching the evils of contact lens abuse and treating unnecessary infiltrates. Fortunately, my patients in daily disposables comply with their wear schedule much better and experience significantly fewer adverse events. My practice experiences have been consistent with other published data showing that nearly nine out of 10 daily disposable lens patients comply with their wearing and replacement schedule (Dumbleton et al, 2009).

Beyond Health and Convenience

While these reasons are all compelling and are why I now dispense daily disposable lenses to all of my new contact lens patients, I had an experience a few years ago that convinced me that all new contact lens patients needed to be in daily disposables, at least for the first week or so. An established overnight-wearing contact lens patient presented for his eye exam. He had been wearing this overnight modality for about three years. The technician asked him to remove his lenses. I happened to walk by and overheard him say to the technician, “You will have to remove them. My wife always puts them in and out for me. I still haven’t been able to do that.”

As I thought it over, I realized that we were at fault, not him. During our initial contact lens trial, he had applied and removed his contact lenses only once. At that point, I vowed that all new contact lens patients in my practice would experience daily disposable lenses first.

I have also found that daily disposables are a good type of lens with which patients can learn. Daily disposable lenses allow patients to work on application and removal without any financial fear of losing or damaging a contact lens. We also don’t have to worry about adverse care solution-related events or complications related to overnight wear. I have witnessed both of these issues ruin the initial contact lens experience for new patients.

What is interesting is that not only has our practice’s protocol change helped patients become more comfortable with application and removal of their lenses, but a vast majority of them have elected to continue with daily disposable lenses after their trial.

Recommend What You Know Is Best

Intuitively, I think we know that daily disposable lenses are the ideal choice. They are convenient for patients, and we appreciate their health benefits. Based upon my experience, I encourage you to let your new contact lens patients know that they can have any contact lens they want as long as it is a daily disposable. CLS

For references, please visit www.clspectrum.com/references and click on document #228.

Dr. Aldridge is a graduate of Southern College of Optometry and practices in Burnsville, NC. He lectures frequently and has written numerous articles on ocular disease, contact lenses, and practice management. He is a consultant or advisor to TearLab Corporation and has received lecture or authorship honoraria from Alcon.