Article Date: 10/1/2010

Lens Solution Compliance: Lessons from a Best Seller
contact lens solutions

Lens Solution Compliance: Lessons from a Best Seller

Creating "real value" and patient accountability via communication is the key to lens solution adherence.

Susan J. Gromacki, O.D., M.S., F.A.A.O., West Point, N.Y.

Freakonomics: A Rogue Economist Explores the Hidden Side of Everything (P.S.) (Harper Perennial, 2009) and its sequel, SuperFreakonomics (William Morrow, 2009) — books that explain human behavior with statistics and economics — reveal that if people recognize real value, they'll pay for it. SuperFreakonomics, in particular, shows that people part with their money more readily if they're aware they're part of an experiment (i.e. if they're being watched.)

Given these books' valid findings, here are four tips to improve patient compliance to your prescribed lens solution. (See "Our Responsibility," below.)

1. Provide a sample care kit

While in the exam room with the patient, initiate the lens care conversation, and hand him a sample care kit (e.g. contact lens case and solution). Because you, the eye doctor, or expert, personally hand the patient the products, this tells him these are the only products he should use. In this case, you, the O.D., represent "real value," making the patient think twice before buying a different solution.

2. Explain your choice

Briefly explain why, specifically, you've chosen a particular lens solution. For instance, you may want to mention how the solution works best with the patient's contact lens material. This conveys to the patient that it's important he stick with your prescribed solution. That said, consider reinforcing this message by saying something like:

"This solution, as is the case with all solutions, is unique. So, it's important you not deviate from this brand. Should you purchase a different solution, you'll be placing your eyes at risk for complications."

By explaining your solution choice, the patient recognizes the "real value" in adhering to your prescribed solution. (See "Contact Lens Solutions," below.)

3. Provide a handout

Give the patient a handout that lists his chosen solution by name and provides details on proper contact lens wear and care. (The use of graphics is especially beneficial.) The handout strengthens the fact that all solutions are unique.

Instruct the patient to read it prior to replacing the complimentary lens solution sample. As SuperFreakonomics revealed, people tend to comply when held accountable.

4. Write a "prescription"

To further strengthen your instructions regarding the patient's lens solution, write the solution's name on your prescription pad, and hand the "prescription" to your patient. This shows the patient that despite the fact solutions can be found on pharmacy shelves, they are, indeed, medical products that require the guidance of a trained eyecare professional. Again, when held accountable, adherence tends to increase.

The key to getting patients to adhere to your prescribed solution is communication. And as the Freakonomics books illustrate, in order for this communication to be successful, it must enable patients to recognize the "real value" in complying with your prescribed solution and should place the accountability on the patient. OM

Our Responsibility
It is our responsibility, as eyecare practitioners, to understand each solution's components (preservatives/surfactants/wetting agents). To acquire the latest information on lens solution components/ interactions, reference the various manufacturers' web sites. Further, keep abreast of any new solution technology. In addition to manufacturer web sites, industry sales representatives are a good source of information.
By understanding this technology, you avoid any learning curve associated with a new product's utilization. And, you reinforce to your patients that each product is unique. This patient knowledge can make a difference in how readily a patient complies with your prescribed care regimen.

Contact Lens Solutions
AQuify Multi-Purpose Solution (CIBA Vision)
Biotrue Multi-Purpose Solution (Bausch + Lomb)
Clear Care Cleaning and Disinfecting Solution. (CIBA Vision)
COMPLETE Multi-Purpose Solution Easy Rub Formula (Abbott Medical Optics)
One Step Hydrogen Peroxide System (Sauflon Pharmaceuticals)
OPTI-FREE EXPRESS Multi-Purpose Disinfecting Solution (Alcon)
OPTI-FREE RepleniSH Multi-Purpose Disinfecting Solution (Alcon)
Oxysept UltraCare Formula Hydrogen Peroxide Solution (Abbott Medical Optics)
renu fresh Multi-Purpose Solution (Bausch + Lomb)
renu fresh sensitive Multi-Purpose Solution (Bausch + Lomb)
Sauflon All in One Lite Multipurpose Solution (Sauflon Pharmaceuticals

Dr. Gromacki is a Diplomate in the Cornea, Contact Lenses, and Refractive Technologies section of the American Academy of Optometry. She is chief research optometrist at Keller Community Hospital in West Point, New York. E-mail her at, or send your comments to

Optometric Management, Issue: October 2010