Looking at studies shows that contact lens wearers continue to abuse lens wear by not following wear recommendations, care regimens, or replacement times. Even with advances in contact lens science, such non-compliance remains a significant problem. Reinforcing education and training plus prescribing daily disposables may help improve compliance.
A common problem
I have figured out that patients’ non-compliance with contact lens wear isn’t my fault.
Although the industry has seen remarkable advances in contact lens science, noncompliance with lens-wearing schedules, replacement schedules, and lens care regimens remains a significant problem. Noncompliance is present across demographic groups and patient types.6 Because it is obviously impossible to convince all contact lens wearers to replace their lenses according to manufacturer recommendations, it is up to the contact lens practitioner to find some way to reduce the risks of contact lens overwear.
The first step is proper patient education and training. As the studies show what we feel is acceptable is quite different than what the patient believes and subsequently what the patient actually does. Constant reinforcement at the time of exam and at all follow-up visits is the first step. Asking the patient to demonstrate how he cares for his lenses often reveals care errors.
Consider switching non-compliant patients to a daily disposable lens. The 2019 Ohio Study3 showed daily replacement wearers were more compliant than two-week and monthly replacement wearers with prescribed lens replacement.
Combine this with the fact daily disposable lenses are associated with a 12.5x lower risk of corneal infiltrative events compared with reusable lenses,7 and it seems the first step is to get patients to a daily modality.
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2. Gyawali R, Nestha Mohamed F, Bist J, Kandel H, Marasini S, Khadka J. Compliance and hygiene behaviour among soft contact lens wearer in the Maldives. Clin Exp Optom 2014 Jan;97(1):43-47.
3. Reuff EM, Wolfe J, Bailey MD. A study of contact lens compliance in a non-clinical setting. Cont Lens Anterior Eye 2019 Oct;42(5): 557-561.
4. Ramamoorthy P, Nichols JJ. Compliance factors associated with contact lens-related dry eye. Eye Contact Lens 2014 Jan;40(1):17-22.
5. Stapleton F, Carnt N. Contact lens-related microbial keratitis: how have epidemiology and genetics helped
us with pathogenesis and prophylaxis. Eye (Lond). 2012 Feb;26(2):185-93.
6. Yeung KK, orister JF, Forister EF, Chung MY, Han S, Weissman BA. Compliance with soft contact lens replacement
schedules and associated contact lens-related ocular complications: the UCLA contact lens study. Optometry. 2010
7. Chalmers RL, Keay L, McNally J, Kern J. Multicenter casecontrol study of the role of lens materials and care products
on the development of corneal infiltrates. Optom Vis Sci. 2012 Mar;89(3):316-25