At the Global Specialty Lens Symposium this year, there was quite a bit of evidence to support that patients are still not quite getting the message about tap water use on their specialty contact lenses. Moreover, as practitioners, we are not providing adequate instructions regarding specific tap water activity—such as not showering in their lenses, the risks of a simple rinse even if followed by disinfection, and not swimming in their contact lenses. Perhaps there are ways that we can improve our communication with patients.

Fixing the Disconnect

In 2018, Konne and colleagues reported that one-third of contact lens wearers did not recall their eyecare provider discussing lens care and wear with them. Moreover, fewer than half recalled hearing their eyecare provider recommend that they not sleep in their contact lenses. In that same report, eyecare providers reported sharing contact lens hygiene and care with their patients at initial encounters, follow ups, and complication-related visits.

A recent 2020 study conducted by the Dry Eye Foundation surveyed scleral contact lens habits of 536 participants. The results clearly demonstrate a disconnect between what eyecare providers think that they tell their patients and/or what patients remember hearing.

More than half of patients surveyed reported rinsing their lenses between disinfection and application. Another significant finding of this study was that more than half of scleral contact lens patients reported that they did not receive written instructions regarding rinsing lenses with tap water as well as cleaning and/or tap water precautions with respect to plungers and cases. Additionally, more than half of respondents did not have clear instructions regarding precautions for showering or swimming in their scleral lenses.

Recommendations

I personally recommend that my patients clean their plungers after each use with an alcohol swab and follow similar recommendations for contact lens case hygiene. We routinely ask our patients about lens care and cleaning at each follow-up and annual visit. This provides eye-care practitioners with an opportunity to provide feedback to patients who may have adopted poor habits over time or who simply misunderstood their practitioners’ directions.

Thus, it is clear that practitioners can do better through improved communication on appropriate scleral lens habits and on the risks of tap water. This can be accomplished through both written instructions and ensuring that all staff involved in patient care are up to speed on these instructions. With many resources available to patients, it may be the right time to consider providing written instructions on care, cleaning, handling, and general recommendations to which patients can refer once they leave the office.

A number of professional, academic, or government organizations offer written information for patients that practitioners can hand out. These handouts include care and handling instructions for both specialty lenses and sclerals. It also offers handouts that discuss proper application and removal of these lenses.

A Good Start

Hopefully, at the start of the next year, patients will have a better grasp of what habits their practitioners would like them to have regarding care and handling of their specialty contact lenses, not to mention less of a disconnect between what they understand and how practitioners deliver this information. CLS

For references, please visit www.clspectrum.com/references and click on document #293.