Years ago, I remember that clinicians in the cataract and refractive surgery fields moved patients expeditiously to surgery when initially indicated. They were often either ignorant to, or dismissive of, the importance of managing pre-existing ocular surface conditions such as dry eye and meibomian gland dysfunction (MGD), particularly regarding their relevance to successful surgical outcomes. Fast forward five to 10 years, and those in these surgical fields have come a long way in understanding the importance of managing ocular surface diseases prior to performing surgery such that it is considered the standard of care by many in the field. We also see related therapeutics being considered postoperatively to help improve healing and related outcomes as well.
I think that a similar evolution in thinking and patient management is starting to happen among contact lens practitioners in this regard. While some “early adopters” in the contact lens field are very proactive in managing ocular surface disease to facilitate successful contact lens wear, I believe this group is a small (but often vocal) minority. With the well-recognized impact of comfort on successful and continued contact lens wear, I wonder whether the contact lens community has reached the same tipping point on this topic as the surgical community of five to 10 years ago. Similarly, as we see more and more management options for dry eye and MGD (for which regulatory approvals often do not include these conditions in contact lens wearers), we will also start to see these management options being extended into the contact lens-wearing population as well. I encourage you to maintain an active presence in managing ocular surface disease in your potential and current contact lens wearers.