ODs strive to always focus on managing the contact lens patient. But sometimes they are tempted to stop shy of 100 percent, especially once a patient’s complaints have quieted. Here’s one such example.
Patient CA presented as a new patient six weeks ago with complaints of mild light sensitivity in both eyes for the past several years. The photosensitivity is constant—but much worse outside—and she needs to wear sunglasses if it is daylight.
Her medical history is unremarkable. She takes birth control pills and 800 mg ibuprofen prn (Advil, Pfizer). She wears Acuvue Vita (Johnson & Johnson Vision) from 7 a.m. to 11 p.m., disposes them monthly, and “never” wears her prescription glasses.
She uses OptiFree Replenish Multi-Purpose Disinfecting Solution (Alcon) for contacts twice a day before contact lens insertion and after removal. CA works on the computer at least 10 hours per day and complains that her eyes are dried out and irritated by evening.
Previously by Dr. Brimer: Troubleshoot contact lens discomfort and prevent complications
An OD’s first impulse is to scream, “Well, of course!”
Ten hours at the computer with contact lenses could cause anyone to be annoyed. But it was clear there was something more causing the light sensitivity CA was experiencing.
Nonetheless, ODs have to be readily armed to discuss computer habits and computer setup, including distance and height, timing of breaks, and inclusion of blink exercises. Career device users are more and more common, and the time to discuss these things continues to diminish.
I urge ODs to incorporate patient education pieces to do the talking. While these tips are second nature to ODs, it needs to be spelled out to patients. Do not take it for granted that they know how to influence their own work environment in a positive way.
CA was correctable to 20/20 OD, OS with a refraction of OD: -2.50 -0.75 x 175 and OS: -3.00 -0.50 x 147. This 38-year-old patient requested an addition of +1.25 D. However, she denied computer or near strain.
1. Rao SN. Topical cyclosporine 0.05% for the prevention of dry eye disease progression. J Ocul Pharmacol Ther. 2010 Apr;26(2):157-164.
2. Blackie CA, Coleman CA, Nichols KK, Jones L, Chen PQ, Melton R, Kading DL, O’Dell LE, Srinivasan S. A single vectored thermal pulsation treatment for meibomian gland dysfunction increases mean comfortable contact lens wearing time by approximately 4 hours per day. Clin Ophthalmol. 2018 Jan 17;12:169-183.