During a CE breakout session during the Global Specialty Lens Symposium on Friday, Jan. 17, Pam Satjawatcharaphong, OD, associate clinical professor at UC Berkeley School of Optometry, and Jennifer Harthan, OD, professor of optometry and chief of the Cornea and Contact Lens Center of Clinical Excellence at Illinois College of Optometry, provided a contact lens care and compliance update. “The status quo of contact lens care is evolving, and rightfully so,” noted Dr. Satjawatcharaphong. “So, this course reviews the most updated guidelines that every practitioner should know, whether in private practice, hospital, or academic settings.” 

She noted that there is a well-established relationship between poor contact lens compliance and adverse effects. She continued that despite being educated about potential serious risk of noncompliance, studies have shown a disconnect between risk awareness and actual compliance by patients.

Dr. Satjawatcharaphong then presented five cases of patients who she had seen in the past year. All represented various ages, genders, and ethnicities, but all ended with their lenses having some exposure to water and they were subsequently diagnosed with Acanthamoeba keratitis (AK). She questioned whether changes in environment are related to an increase in the number of AK cases. She also speculated that the higher temperatures being experienced in her region could compromise water sources.

She explained that AK is notorious for being difficult to diagnose in early stages due to nonspecific clinical signs and that practitioners are most familiar with late-stage signs of infection, but prognosis is poor once it has reached this stage. Therefore, she stressed that early detection and confirmation of diagnosis is critical for a good outcome.

Dr. Satjawatcharaphong noted that primary eyecare providers, staff, and students will often be the first line of defense against these pathogens via their education of patients or by knowing best practices to manage these cases when they occur. “It is up to us to proactively reeducate our patients about the products,” she said.

Next, Dr. Harthan reviewed strategies to support adherence to multipatient contact lens disinfection recommendations, such as potential collaboration with lens manufacturers; in-office tips were also covered.

It was shared that for both patients and practitioners, handwashing is the most important measure to prevent the spread of infection. Other things that are also helpful include personal protective equipment, vaccinations, respiratory hygiene, single-use instruments/equipment/contact lenses, reprocessing of reusable items, environmental cleaning, and waste management.

Dr. Harthan provided results from one survey in which 86% of respondents believed they were compliant, while only 34% were actually compliant. To try to increase compliance, Dr. Harthan noted that she has started to “prescribe” specific care systems as well as offer those products in the office.

She also pointed to several resources that are available for practitioners that provide step-by-step instructions for cleaning and disinfection of lenses from the American Academy of Optometry, the American Optometric Association, and the GP Lens Institute.

“We realize how important this is, but don’t always put as much emphasis as we should,” says Dr. Harthan. “Everyone should understand that cleaning and disinfection are two separate things, but they need both.”