Article

CLINICAL: Contact Lenses

When Patients Stop Lens Wear

Let’s remain positive and use these instances as learning opportunities

Failures can be hard to swallow with anything in life, and contact lens failures can be just as difficult. Unfortunately, contact lens failures happen to me all the time. From single vision spherical to toric multifocal designs to specialty lens designs, among others, not everyone is successful with the contact lenses we prescribe. This lack of success could be comfort related, vision related, lifestyle related or some other reason. The important thing is to learn something with each one. With that, here are some key takeaways I’ve learned from contact lens failures.

1 GIVE IT EVERYTHING YOU GOT

When doctors get frustrated with their patients — usually when something is not going the way they expect, the patient can feel that and get just as frustrated, often leading the patient to give up. For example, presbyopic contact lens fits can be the most frustrating and challenging, due to the repeated ongoing discussions about expectations and repeat visits. I often find myself in the middle of these situations. I have to continually check myself, and give it everything I’ve got. Following the fit guide will often minimize the time to fit these lens designs, but also two patients with the same spectacle prescription can be fit with the same lens and have drastically different experiences, depending on their expectations and lifestyles. We must recognize that it may take an extra visit or two, that sometimes we have to start over with a different lens design and see what happens, but, to never let them see us sweat.

A COOPERVISION-COMMISSIONED SURVEY OF CONTACT LENS WEARERS reports that AT 3 and 6 MONTHS OF starting WEAR, 31% SAY THEY WILL STOP WEARING LENSES IN THE NEXT 6 MONTHS. At 12 MONTHS OF WEAR, ONLY 18% SAY THEY WILL cease WEAR IN THE NEXT 6 MONTHS.

2 UNDERSTAND WHY THE PATIENT DECIDED TO CEASE WEAR

This circumstance may not occur during the contact lens fitting or follow-up, but rather at future exams. For example, I recently had a teenage contact lens-wearing patient present to her eye exam with her glasses on. That happens, on occasion, but this patient said that “contact lenses just did not work” for her. Instead of taking that response and moving on to the next procedure, let’s dig a little deeper. After questioning why the lenses did not work out, the patient stated that it took too long to put them in, in the morning, and she valued an extra few minutes of sleep. My only option here was to explain that my office staff is here to help her improve insertion techniques as well as let her know she is still a great candidate for contact lenses, when she is ready to start over.

3 REMIND PATIENTS ABOUT FUTURE DEVELOPMENTS

I recently had a patient drop out of contact lens wear due to contact lens-related dry eye. I refit this patient in multiple lens designs, but none of them satisfied his comfort level. He needed advanced dry eye treatment after discontinuing lens wear and, maybe, contact lenses were not right for him at that time. I reminded him that contact lens manufacturers are constantly looking to develop the next best thing and to consider trying something new in the future.

IT HAPPENS

Contact lens failures or dropouts happen, but we can learn from each to inform our services in the future. Let’s react with positivity, and continue to educate patients about future developments in the contact lens world. Many of these patients will re-engage in contact lens wear again. OM