Dr. Brimer is a graduate of UNC-Chapel Hill and Southern College of Optometry. She is a fellow of the American Academy of Optometry and is very active in the American Optometric Association as a member of the North Carolina State Optometric Society’s Exec
It is a constant challenge to be able to inspire patients to care meticulously for their lenses when life is easy, but what happens to that care when life gets hard? What happens when their schedules are upside down, and they are on the go? Travel influences how patients wear and care for their lenses-let’s look at the how, why, and most importantly, what we can do about it.
We all know that how a patient cares for her contact lenses can have a potential effect on her vision, comfort, and overall lens-wearing experience. We all know that, right? It is a constant challenge to be able to inspire patients to care meticulously for their lenses when life is easy, but what happens to that care when life gets hard? What happens when their schedules are upside down, and they are on the go? Travel influences how patients wear and care for their lenses-let’s look at the how, why, and most importantly, what we can do about it.
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When a person travels, everything in her world can become hectic and rushed. When this happens, contact lens wear and care may be pretty low on the list of priorities. Most of my patients want to wear their contact lenses on vacation more than any other time. Because of this, some travelers may be novice contact lens wearers at best.
Others may choose to wear their glasses or go without correction altogether, but this probably represents the minority. Most tend to shift in the opposite direction, wearing their lenses for significantly more hours than normal or even sleeping in their lenses when they normally wouldn’t. Through television and other various avenues, many consumers are aware that extended wear lenses allow people to sleep in their lenses for a week or more.
So, while they may not be wearing an extended wear lens, they might use this knowledge to justify these rare indiscretions, thinking it couldn’t be that bad. Others remove their lenses daily but may not rub, rinse, and replace due to fear of running short on solution.
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Even when travel is well planned, sometimes conscious choices are made to omit needed items. After all, space is limited. I know the real estate in my suitcase has a Beverly Hills market value! Another roadblock comes when you consider the liquid regulations for carry-on baggage. Without a three-ounce bottle on hand, the patient is more likely to abandon the solution than check the bag. And if he can’t make it to the store once on the ground, he’s left with the dilemma of reusing the solution in the case or sleeping in his lenses. Unfortunately, many consumers may not be well educated on the consequences of such behavior.
As I sit on this five-hour flight to Vision Expo West in Las Vegas, I think about what this would mean for the average contact lens wearer. At this moment, I am one hour into the flight, and even without my contact lenses in, I am more aware of my eyes than any other body part! (OK-my elbows are a not-too-distant second.) I’m headed from the beach to the desert, and though it will be late, I have no intentions of turning in when we land. This combination alone can equate to an ocular surface disaster.
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For me, most conventions are full of great moments, networking, and spending time with good friends rarely seen. For many, this leads to late nights and a higher-than-average level of alcohol consumption. If we add that to the first set of challenges, things continue in a downward spiral.
Even if it’s a quiet business trip alone, there could be sleep challenges due to jet lag, workload, or hotel pillows. For some, heightened allergies are added into the mix, disrupting the tear film even more. Any of these can compromise the ocular surface, and when combined, they can cause significant awareness and discomfort. Throw overwear into the mix, and it’s no wonder that patients get discouraged.
Suddenly, eyes and lenses that are typically quiet are now screaming for attention! At this point, dry eyes, inflammation, and redness ensue, but the traveler continues to wear the lenses because, from her perspective, the trip is short and the demands are high.
Of course, it would be slightly reassuring to think that the “professional” traveler knows what to expect, how to prepare, and ultimately how to avoid the common pitfalls causing contact lens discomfort, but this may not be the case. I consider myself a professional traveler, as well as an eyecare professional, yet at times I still make conscious decisions that I know will negatively affect my wearing experience. So, how could I expect my patients to avoid these conditions without exception? Instead of hoping for the unattainable, let’s think through how we can better equip them.
While we may be well aware of the gap between where we are and where we need to be in regard to patient compliance in lens care, I think that gap widens even more when it comes to travelers, especially the “occasional” traveler. So, what can we do to ease the discrepancy between ideal and reality when it comes to compliance and comfort? The first step is certainly to raise our own awareness.
Despite my own travel frequency, I don’t always think of asking my patients about theirs. In fact, now that I think of it, I may add one more question to my entrance form (No, there’s plenty of room!). And once we ask, an opportunity to educate will naturally follow.
I discuss the need to reduce wear time instead of increasing it whenever possible. I tell them, at the very least, to keep account of wear time and environmental influencers. After all, what you don’t measure, you can’t improve. I ask them to consider not wearing their lenses in flight. And if there is any question of an allergic component during travel, I go ahead and prescribe an allergy drop to have on hand.
I like to give these specific patients two sample solution kits (shhh, don’t tell), reminding them to always keep a new travel-size bottle in their cabinets ready to go. Usually in every travel aisle, they can find travel-size multipurpose solution for purchase.
But I do this to emphasize that it is still important to maintain-and therefore plan for-proper cleaning habits, even on a short trip. I also tell them to carry rewetting drops with them at all times, even if they don’t typically need them at home. If the patient does occasionally suffer from dry eyes at home, I will beef up their dry eye treatment permanently in order to prepare them for these more challenging circumstances on the road.
Equally as important, I discuss daily disposable lenses with these patients. If they travel a moderate amount and are resistant, I ask them to consider adding on one 90-day supply per eye to accompany the purchase of their reusable lenses and earmark these for travel. I am very adamant about the value of daily disposables for all my patients, but in these cases, I probably spend even more time discussing the benefits.
If they are still resistant, I give them a 10-day supply of my most comfortable daily disposable lens and tell them to save it for their next trip.
These patients are tagged in our system to receive an email mid-year that shares tips on eye care and comfort during travel as well as general travel tips. We also remind them that we are available to help them feel their best during their travel, and that it is attainable.
So, many times in my home airport, I have gotten off my second or third flight for the day and walked that same long walk to the parking lot. Along the way I pass several posters advertising local businesses, and I’ve often wondered how many people might be juggling artificial tears while dragging their suitcase behind. Those posters may actually be an ingenious way to use that opportunity of timing to generate new business!
As always, I leave you with the same charge: whatever it is-do something! These patients represent considerable potential for the practice. Their demands are great and so are their needs, which means you have an opportunity to exceed expectations and create loyalty. And with this loyalty comes referrals, so don’t negate the impact these traveling contact lens wearers can have on the practice.
In addition to the potential gain from better preparing these travelers, there can be a high-priced penalty for ignoring them. We are often reminded of the surprising frequency of contact lens dropout, so it could be a dangerous practice to disregard even the routine discomforts a contact lens patient may suffer.