At the beginning of this year, the New York City-based Vision Path Inc., online seller of direct-to-consumer Hubble lenses, was required to pay penalties totaling $3.5 million to settle Federal Trade Commission (FTC) charges that it violated the Contact Lens Rule (FTC, 2022). This was huge news in our industry, as it addressed several concerns that we have raised over the last few years.

While there were several issues addressed by the FTC, one of the violations that really hit home was the company’s attempts to substitute Hubble lenses for those prescribed to patients.

It is important that we send a clear message to our patients, and the community, that our prescribing of contact lenses is specific and with purpose, as we are trained and licensed to do so. The public must be made aware that eyecare practitioners make evidence-based decisions for our patients’ health and success with medical devices.

Defining Values

The BCLA Contact Lens Evidence-based Academic Report (CLEAR) provides excellent examples of how eyecare professionals can continue to promote an evidenced-based practice. As defined in the report, an evidence-based practice is the “conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” (Wolffsohn et al, 2021).

We should be integrating the best available and clinically relevant scientific research evidence with a clinician’s expertise, the practice context, and individual patient values.

While there is a lot to unpack within this report, a very important section speaks to the “individual patient values.” As practitioners, this has everything to do with our patient communication. How much is known about your patients, and how much of their lifestyles are involved in contact lens fitting?

Do patients have more active outdoor lifestyles than when initially fit with a monthly modality several years ago? Are the patients’ current daily disposable lenses meeting the demands of recent changes at work and longer computer hours?

Learning facts like these will help tailor a more specific management approach for patients. While these conversations occur within the exam room, many practitioners have also found success with questionnaires dialed into the patients’ subjective experiences with contact lenses (Wirth et al, 2016).

An evidence-based approach can start with communication, but it spreads throughout the exam, from the anterior segment evaluation to evaluation of the fit along with follow-up care. With new contact lens wearers, make sure that handling, vision, and comfort are optimal. Routinely follow up with patients to make sure to address potential dropout issues (Sulley et al, 2017). With long-standing contact lens patients, problems tend to be comfort-related, demonstrating the need to focus more on materials and lens care systems (Dumbleton et al, 2013).

Implementing an evidence-based approach for your patients ultimately comes down to being proactive. We owe it to our patients to continue to offer the best possible experience with contact lenses.

So, let’s continue to support the evidence-based clinical practice through every part of the contact lens-fitting process. CLS

References

1. Federal Trade Commission. Vision Path, Inc., Online Seller of Hubble Lenses, Settles Charges It Violated the Contact Lens Rule and FTC Act to Boost Sales. 2022 Jan 28. Available at https://www.ftc.gov/news-events/press-releases/2022/01/vision-path-inc-online-seller-hubble-lenses-settles-charges-it . Accessed April 4, 2022.
2. Wolffsohn JS, Dumbleton K, Huntjens B, et al. CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye. 2021 Apr;44:368-397.Wirth RJ, Edwards MC, Henderson M, Henderson T, Olivares G, Houts CR. Development of the contact lens user experience: clue scales. Optom Vis Sci. 2016 Aug;93:801-808.
3. Sulley A, Young G, Hunt C. Factors in the success of new contact lens wearers. Contact Lens Anterior Eye. 2017 Feb;40:15-24.
4. Dumbleton K, Woods CA, Jones LW, Fonn D. The impact of contemporary contact lenses on contact lens discontinuation. Eye Contact Lens. 2013 Jan;39:93-99.