The Top Five For Daily Disposables
contact lens management
The Top Five For Daily Disposables
Why you should select this modality for your contact lens patients.
SUSAN KOVACICH, O.D., F.A.A.O.
In the world of contact lens replacement schedules, “one size fits all” or even “one size fits most” doesn't apply. Contact lenses should be tailored to best meet the needs of the individual patient. Daily disposables offer an easy to remember replacement schedule, negate the need for disinfecting solutions and can be the best option for many patients.
Here are my top five reasons to select daily disposable contact lenses for my patients:
# 5 OCCASIONAL WEAR
Numerous patients wear glasses the majority of the time, but switch to contact lenses for specific reasons. If I have patients who tell me that they only wear their contact lenses two or three times a week (or less) and do not desire to wear them on a more regular basis, I will offer daily disposable lenses as the first option. Most patients don't routinely change the disinfecting solution while the contact lenses are sitting in the case, and this increases the chances of contact lens complications. I would prefer that the patient open a new contact lens stored in sterile solution.
Wearing daily disposable lenses on an occasional wear basis also brings down the cost to the patient, often to the same amount as a two week or monthly replacement lens.
Prime Candidates: Patients who prefer their vision with spectacles, Weekend Athletes
One of the main reasons for contact lens dropout is discomfort1, and most lenses become significantly less comfortable over time. A decrease in comfort can be caused by debris building up on the lenses, a problem which can be easily solved by replacing lenses daily. Multipurpose solutions are designed to be safe for use on the eye, but the fact is that they are also designed to be toxic to microbes, and may be too harsh for some patients. Daily disposable replacement avoids solution toxicity and the interaction of solutions with contact lens materials. Dry eye patients may benefit from wetting agents, which are added to the packaging solution of some daily disposables, and some daily disposable lenses have additives that leach out of the lenses during the day to improve comfort.2
Prime Candidates: Sensitive Patients, Dry Eye Patients
# 3 ALLERGIES
Allergic individuals also have comfort issues and are some of the most difficult patients to keep in contact lenses, especially during their allergy season. Again, the daily disposable modality leads to a lens that is as clean as possible everyday, not coated with airborne allergens, and avoids potential sensitivities to disinfecting solutions. Sometimes I have allergic patients wear daily disposables during their worst months and switch back to another modality if the patient prefers for the rest of the year.
Prime Candidates: Allergic Patients
Many patients, if not most, are non-compliant with contact lens wear, replacement and disinfection3,4. Compliance can be improved by making things as simple as possible, following the KISS principle (Keep It Simple, Sweetheart.) An easy-to-remember wearing and replacement schedule, along with no cleaning regimen or solutions to manage, make the daily disposable regimen the simplest contact lens modality available. The rate of compliance has been shown to be the highest with the daily disposable schedule.5 Because daily disposables make replacement and care easier, they are often recommended for younger patients (children and teenagers).6
Prime Candidates: Non-Compliant Patients, Younger Patients
AND THE #1 REASON: CONVENIENCE
Daily disposable lenses are actually my preferred contact lens modality. If I, as the doctor, choose to keep things simple, not deal with disinfecting solutions, and prefer the comfort of a lens that I change every day, wouldn't I offer these same benefits to my patients? This practitioner will continue to wear daily disposable contact lenses as long as possible (on a daily disposable wear basis, of course.)
Prime Candidates: Busy Patients (Moms, College Students, Travelers, Business People, Everyone Else)
Many patients can benefit from the advantages offered by daily disposable contact lenses. Listen to your patients, ask the right questions and look for patients who could gain from the daily disposable modality. At the time of this writing there are no silicone hydrogel daily disposable lenses available in the United States, so the daily disposable hydrogel lens option would not be my first choice in a patient with problems with corneal hypoxia, but as noted earlier, there is no “one size fits all” contact lens option. OM
1. Pritchard N, Fonn D, Brazeau D : Discontinuation of Contact Lens Wear : A Survey. International Contact Lens Clinic 26 (6): 157-162, 1999
2. Pence N. Time to Reconsider Daily Disposable Lenses. Contact Lens Spectrum. September 2008
3. Donshik PC, Ehlers WH, Anderson LD, Suchecki JK. Strategies to better engage, educate, and empower patient compliance and safe lens wear: Compliance: What we know, what we do not know, and what we need to know. Eye Contact Lens 2007;33 :430-3; discussion 434.
4. Collins MJ, Carney LG. Patient compliance and its influence on contact lens wearing problems. Am J Optom Physiol Opt l986; 63:952-956
5. Dumbleton K, Woods C, Jones L, et al. Patient and practitioner compliance with silicone hydrogel and daily disposable lens replacement in the United States. Eye Contact Lens. 2009; 35(4):164-71.
6. Walline J, Long S, Zadnik K. Daily disposable contact lens wear in myopic children. Optometry and Vision Science 2004:81 (4):255-9.
DR. KOVACICH IS AN ASSOCIATE CLINICAL PROFESSOR IN THE CORNEA AND CONTACT LENS CLINIC AT THE INDIANA UNIVERSITY SCHOOL OF OPTOMETRY. DR. KOVACICH IS A FELLOW IN THE AMERICAN ACADEMY OF OPTOMETRY AND HAS BEEN ACTIVE IN THE ASSOCIATION OF OPTOMETRIC CONTACT LENS EDUCATORS. E-MAIL DR. KOVACICH AT SKOVACH@INDIANA.EDU.
Optometric Management, Issue: March 2010