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Successfully converting patients into daily disposable contact lenses (DDCL) is a passion for our team. This passion is rooted in our striving to deliver the highest quality eye care and patient education that we can. Eye care professionals know the benefits of DDCLs, but our patients often do not. In many instances, the education we give to our patients is just as important as the comfort and vision that they receive from the lenses themselves.
A FAIL-SAFE OPTION
An important point that we drive home to patients is the risk factors that are alleviated by converting to DDCLs. One study found that 86% of patients believed they were compliant with lens wear and care practices, but only 34% actually were.1 Based on this finding alone, fitting a patient with a single-use lens is helping them in a way they cannot or will not help themselves.
One of the opticians in our practice is forever coming up with new analogies for why disposing of a lens every day is the healthiest contact lens wear modality. Recently, for example, he compared using a monthly contact lens to reusing a paper plate for every meal. Although crude, this comparison makes a big impact once the patient thinks about it. In the exam room, our prescriptions for DDCLs are never arbitrary; they are targeted to a specific area of the patient’s visual state or lifestyle need.
The process of providing the utmost care and education for our contact lens patients is a team effort. The preemptive work that we do could help to avoid problems down the line, such as the need to treat common conditions associated with extended wear lenses—conditions such as giant papillary conjunctivitis and keratitis. Nearly 1 million US health care visits for keratitis (inflammation of the cornea) or contact lens complications occur annually, at a cost of $175 million.2
Our goal is to be proactive in getting the patients onboard with immediate comfort and quality vision that promotes the health and wellness of the eye. For some practitioners, this is a paradigm shift from their traditional mentality. We must act, rather than react to deliver the best contact lens care.
THE RULE OF TWO
We attempt to give our patients choices founded on a need-based analysis. A patient’s workup is more than just testing. Our technicians document what a typical day is like for each patient, including computer use and leisure activities.
Once the patient’s ocular and lifestyle needs are identified, we use what we call the “Rule of Two.” Essentially, this means giving each patient two choices of lenses. We educate about the products, how each will specifically benefit the patient, and what, if any, tradeoffs may exist.
Patients already wearing a single-use modality hydroxyethylmethacrylate, or HEMA, lens will be given a choice of two different silicone hydrogel (SiHy) DDCLs. Some patients who are on a part-time wear basis or are budget-minded will be given one SiHy and one HEMA option.
This Rule of Two is a great starting point for patients new to the practice, but it is also appropriate for others, including noncompliant, overwearing monthly replacement patients. These patients, too, are given a choice and provided education on benefits and tradeoffs. They will leave the office with an ample supply of single-use lenses to try, as well as the option of continuing with their traditional monthly lenses if they are insistent. Although our team always puts in the work, we pick and choose our battles.
It is no secret that DDCLs cost more than their monthly or biweekly counterparts. This is the elephant in the room when we suggest the daily modality to a long time monthly wearer. Prescribing DDCLs is always to be done on a needs-based analysis, reinforced with education of the patient. Education should include not just how the lens works or why the patient needs it, but also what problems he or she has that will be solved with the daily modality.
This process takes effort, and, much to the chagrin of some, it also takes time. In the end, however, patients are more than happy to invest in a product that will add hours of comfort to their day, keep their eyes from being dry and blurry while driving home at night, and reduce the risk of infection. These are real problems for patients, and if they qualify themselves for a solution in the exam room, they are more than likely willing to invest in it.
FITTING THE NEW GENERATION
Fitting DDCLs for millennials is one of our keys to success. Millennials have a mindset to embrace things that will make their life easier. Among our patients, the millennials are the demographic group that most readily embrace the most advanced SiHy single-use lenses.
A key factor in presenting this option to millennials is opening up a dialogue with them about the amount of time they spent looking at device screens, followed by education about the reduced blink rate with screen use and the symptoms such as discomfort and blurred vision that are associated with it. A study in 2011 found that participants had an observed average blink rate of 18.4 per minute prior to use of a visual display terminal, dropping to 3.6 per minute during use.3 This wreaks havoc on the patient’s comfort and wear time in contact lenses.
We embrace technology and accept the fact that the science behind eye care is going to have to adapt to it. Millennials grew up with cell phones in their hands and computers at home and work. Why would we fit them with a lens researched and designed before the era of modern technology?
Our patients often share a laugh with us as we add up all their weekly screen time. The numbers can be staggering, especially for teenage patients. They (and their parents) appreciate what impact this has on their eyes after some simple education from our team and even from the signage around our office.
Growing up as a child, exploring the equipment in my father’s optical store in my home state of Nebraska, I was always filled with curiosity. I would ask my dad, “How does this help people see better?” To this day, I still carry this passion. Technology continually offers more and better solutions to contact lens wearers. Contact lens patients who enter my office are always offered the best care and products to allow them to make an educated decision. We try to educate them with the same simplicity and transparency that even a child would understand.
1. Bui TH, Cavanagh HD, Robertson DM. Patient compliance during contact lens wear: perceptions, awareness, and behavior. Eye Contact Lens. 2010;36(6):334-339.
2. Cope JR, Collier SA, Rao MM, et al. Contact Lens Wearer Demographics and Risk Behaviors for Contact Lens-Related Eye Infections--United States, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(32):865-870.
3. Rosenfield M. Computer vision syndrome: a review of ocular causes and potential treatments. Ophthalmic Physiol Opt. 2011;31(5):502-515.
Samuel J. Teske, OD, PA
• Private practice at The Eye Doctors of New Tampa in Tampa, Florida
• firstname.lastname@example.org; (813) 632-2020
• Financial disclosure: speaker for Cooper Vision and Johnson & Johnson
Kevin Christian, CPOA
• Optician, The Eye Doctors of New Tampa in Tampa, Florida
• email@example.com; (813) 632-2020
• Financial interest: none acknowledged