It has never been more clear to me how important it is to evaluate and treat the ocular surface for all patients—but especially for contact lens wearers. This evolution has happened throughout my career, but even more so now as it has started to affect me: I have been a contact lens wearer for more than 30 years (my first set of contact lenses was at the age of 12), and I am now beginning to experience symptoms of dry eyes with lens wear!

Be Empathetic in Your Approach

It is so easy to take a passive approach to this condition and the subsequent treatment offered. Take a second to put yourself in your contact lenswearing patients’ shoes when they present with any type of ocular surface disease. For example, which of the following management strategies would you prefer hearing from your practitioner?

Option 1 “Dry eye is a common condition that affects millions of people. There really is no cure for the condition. Your current contact lenses are an older brand, but they are cost effective and seem to be working OK. Take breaks from the computer as often as you can during the day, and here are some over-the-counter eye drops that you can try out and see whether they help. Call back if you have any other issues.”

Option 2 “Dry eye is a relatively common condition that can complicate contact lens wear for sure! You may not know this, but a large percentage of patients who suffer from dry eyes have poor eyelid meibomian glands. These conditions complicate each other and can make your lenses more difficult to wear because of reduced comfort and vision that is not as sharp as it should be. Here is a picture of your ocular surface. You can see where the dry areas are (Figure 1).

“For those reasons, we need to be aggressive and consistent with our treatment plan:

(For current reusable wearers) “I know that you’ve been wearing (two-week or monthly) reusable contact lenses, but I have found better success with vision and comfort using newer moisture-rich daily disposable lenses. I’d like to start you on this specific eye drop daily, these eyelid hygiene products, and a diagnostic pair of these innovative contact lenses. Let’s schedule you back in a few weeks to see how this is working out and to make further changes, if necessary. We now have advanced treatments for your ocular surface and eyelids if this does not treat your condition.”

(For current daily disposable wearers) “I know that you’re currently wearing daily disposable contact lenses, which are a good option for patients who have dry eyes, but there have been some new, moisture-rich daily disposable lenses launched in the past few years. These lenses will most likely provide longer lasting comfort and improved vision compared to your current lenses. I’d like to start you on this specific eye drop daily, these eyelid hygiene products, and a diagnostic pair of these innovative contact lenses. Let’s schedule you back in a few weeks to see how this is working out and to make further changes, if necessary. We now have advanced treatments for your ocular surface and eyelids if this does not treat your condition.”

The Choice Is Clear

Don’t take the easier, passive approach with these patients. They are frustrated from this condition, and they deserve the best treatment. Actively seek out and aggressively treat these patients. They present themselves on a regular basis. These happy, healthy contact lens wearers will often refer other potential contact lens wearers to your practice. CLS