Article Date: 1/1/2006

contact lens management
Improving Compliance
The right solution is a critical component to contact lens success.
GLENDA B. SECOR, O.D., F.A.A.O.

When colleagues ask me why I've been successful in building a specialty contact lens practice, I am quick to point out that you can't be complacent about technology or you will be left behind. I primarily recommend silicone hydrogel contact lenses because of their high oxygen transmissibility, wettability, and improved end-of-day comfort with less redness.

However, technology hasn't eliminated some age-old compliance issues. In my practice we often see higher rates of infiltrative keratitis and other hypoxia-associated complications among young adults who may abuse their lenses more frequently. Here are my tips for beating this problem.

Nipping it in the bud

I've observed that this same patient segment also can have a high rate of contact lens non-compliance issues — whether it's regularly sleeping in their old HEMA lenses or not caring for them properly. For these patients, I recommend a continuous-wear silicone hydrogel lens. Providing the most oxygen permeability available potentially reduces the risk of hypoxic complications and other problems when patients sleep in their lenses. I also select a solution designed to maximize the performance and comfort of this advanced material.

Solutions matter

Several studies show that 46% to 57% of all contact lens wearers are non-compliant when it comes to their wear and care schedule. Since we have limited opportunity to reverse this behavior, we must feel confident that we've informed patients about why the solutions we recommend are important to their contact lens success.

People are interested in products that are effective, simple and fast. For these patients, CIBA Vision's Aquify 5-Minute multi-purpose solution is a good choice. It can clean and disinfect in a rapid format so patients know their lenses are ready to wear even when cleaning time is limited. Currently, no other solutions have five-minute approvals.

Tips to Keep Them Compliant

Emphasize the difference in lenses and the importance of proper care products to enhance wearability.

Review at each visit the current care products patients are using, correct non-compliant behavior and explain why.

Bundling care products with lenses assures compliance with recommended products and reduces the risk of substitution of non-recommended solutions.

My rule of thumb for silicone hydrogel contact lens patients who have either sensitive eyes or heavy lipid deposits is to recommend a peroxide lens care solution. Based on my experience, these provide the patient with fresher, cleaner, more comfortable lens wear, and reduce surface depositions. For patients who are sensitive to preservatives, I recommend CIBA Vision's Clear Care for a thorough cleaning. The elimination of preservatives often reduces sensitivity problems.

It's the seemingly little things

The bottom line is that you can differentiate your practice from the majority of others if you take the time to ask your patients when and how they wear, and how they care for, their contact lenses. Using the proper care products for these advanced materials can make a big difference in the lens-wearing experience. It can also reduce the number of unhappy patients, who ultimately could drop-out of contact lens wear. OM

References available upon request.

DR. SECOR IS IN PRIVATE PRACTICE IN HUNTINGDON BEACH, CALIF. SHE IS A FELLOW OF THE AMERICAN ACADEMY OF OPTOMETRY AND A DIPLOMATE OF THE CORNEA & CONTACT LENS SECTION. SHE IS ALSO AN EXPERIENCED CLINICAL INVESTIGATOR AND A FREQUENT LECTURER ON THE TOPIC OF CONTACT LENSES.



Optometric Management, Issue: January 2006