Few Contact Lens Users Follow Recommended Lens Care

'Essentially All' Patients Fail to Follow Care Steps—Even Though They're Aware of Complication Risks

Newswise — Philadelphia, Pa. (November 30, 2011) – Most people who wear contact lenses perceive themselves as following standard guidelines for lens wear and care—but only a tiny minority are actually compliant with all recommended care steps, according to a study in the November issue of Optometry and Vision Science, official journal of the American Academy of Optometry. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

A "significant proportion" of patients don't follow recommended care even though they're aware that their behavior places them at increased risk of complications, according to the new research by Danielle M. Robertson, OD, PhD, and H. Dwight Cavanagh, MD, PhD, of The University of Texas Southwestern Medical Center, Dallas.

More than 80 Percent of Patients Say They Follow Recommended Care…The researchers analyzed contact lens care practices and knowledge of complications and risk factors in two groups of contact lens wearers: 281 patients visiting a random sample of eye care practitioners in the Dallas-Fort Worth area and 152 seen at a university eye clinic.

In both groups, most patients could name a complication related to contact lens wear: 58 percent in the general community and 91 percent at the university clinic. The most commonly named complications were those related to lens comfort/handling and infections.

Differences in knowledge and perceptions between groups likely reflected the higher rate of significant eye problems in the university group. There were only marginal differences in contact lens-related complications between groups.

Most patients could identify important risk factors for lens-related complications. These include "topping off" rather than replacing contact lens solution; exposing lenses to tap water, including wearing lenses while showering; and poor hygiene practice. "Overall, 85 percent of patients perceived themselves as compliant with their lens wear and care practices," Drs Robertson and Cavanagh write.

…But Only Two Percent Have Good ComplianceHowever, when the researchers used a standard model to determine the patients' actual level of compliance with recommended care steps, the results were very different. In this model, compliance was rated good for only two percent of patients. "The average contact lens wearer only performed 50 percent of the recommended behaviors," according to the authors.

Just one patient was "fully compliant" with all recommended contact lens wear and care practices: a rate of 0.4 percent. Drs Robertson and Cavanagh point out, "While most patients consider themselves to be complying with standard practitioner guidelines for lens wear and care practices, essentially all contact lens wearing patients exhibit behavioral non-compliance with resulting increased risk for significant complications."

Given that most patients knew the risk factors for complications yet very few followed recommended care steps, "[A]wareness of risk alone is not a driving factor establishing compliant behavior," the researchers write. Failure to follow recommended lens care a "persistent clinical problem" for eye care practitioners. Despite low compliance rates reported in this and previous studies, rates of severe complications associated with contact lens wear are relatively low.

Since patients are already aware that not following recommended lens care increases their risk of complications, further education doesn't seem likely to lead to long-term changes in behavior. "New strategies and approaches to effectively modify inherent patient non-compliance are urgently needed," Drs Robertson and Cavanagh conclude.

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About Optometry and Vision ScienceOptometry and Vision Science, official journal of the American Academy of Optometry, is the most authoritative source for current developments in optometry, physiological optics, and vision science. This frequently cited monthly scientific journal has served primary eye care practitioners for more than 75 years, promoting vital interdisciplinary exchange among optometrists and vision scientists worldwide.

About the American Academy of OptometryFounded in 1922, the American Academy of Optometry is committed to promoting the art and science of vision care through lifelong learning. All members of the Academy are dedicated to the highest standards of optometric practice through clinical care, education or research.

About Lippincott Williams & Wilkins Lippincott Williams & Wilkins (LWW) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services.

LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2010 annual revenues of €3.5 billion ($4.7 billion).