■ Check contact lens fit. Patients who present with symptoms of dry eye after wearing contact lenses should be evaluated for contact lens fit before switching to another contact lens, contact lens care product or dry eye product. It' s important to check the contact lens-cornea relationship to assist the patient with comfort. Steeping the base curve of a silicone hydrogel contact lens may provide symptomatic dry eye relief. Once the fit of the contact lens is optimal, a lubricating drop may be appropriate to ensure end-of-day comfort and increase wearing time.
■ Inquire about medications. Ask the patient about changes in medications and the nature of the medications. Many common drugs (ie, antihistamines, diuretics and antidepressants) can decrease tear production. Some alternative herbs and medications also interfere with prescription medications, and should be investigated when evaluating symptoms of dry eye.
■ Elicit self-medicating strategies. Patients have a tendency to selfmedicate, so remind them to have patience. Contact lens-induced ocular dryness may be irritating but it's manageable. Schedule follow-up exams to help patients identify the environmental etiology of ocular dryness, and prescribe lubricating or gel drops as your first line of defense.
■ Educate about warning signs. Educate all patients on the red-light warning signs of ocular pain and redness that need immediate attention.
■ Use fluorescein. Fluorescein is easy to use and can tell us a great deal about our contact lens patients. It's important to use fluorescein with a Wratten barrier filter on every contact lens patient.
Optometric Management, Issue: October 2009