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Dry eye with contacts requires advanced approach
 Michael D. DePaolis |
When I completed my optometric training more than 25 years ago, I had the good fortune to join the renowned practice of Dr. Robert Morrison. As a specialty contact lens practice we saw our share of complicated patients. While our patients’ problems were quite varied, one of the most common related to dryness.
At the time, I attributed many of these problems – dryness included – to the fact that the majority of these patients were wearing PMMA- or HEMA-based contact lenses. Surely, I thought, it is just a matter of time before we eliminate dryness associated with contact lens wear.
Fast forward to 2011 and, well, you know the rest of the story. The good news is that the contact lens industry is thriving, with the number of wearers worldwide at an all-time high. The industry’s success is largely due to tremendous advances made in materials, designs, prescription options and lens care products. Indeed, today it is easier than ever to work with contact lenses. Easier, that is, until you encounter dryness.
Dry eye remains one of the most vexing clinical conditions encountered in optometric practice today. Add a contact lens to the mix and it only gets more complicated. For sure, to successfully tackle the contact lens dry eye patient requires a thorough and systematic clinician and a committed and compliant patient.
Compared to 25 years ago, today we take a more global approach to managing dry eye in the contact lens patient. First and foremost, we need to aggressively treat the underlying dry eye, especially when lid disease is involved. Lid hygiene, omega-3 supplementation and antibiotic and anti-inflammatory agents provide us with much better outcomes than ever before.
To be successful, we must also embrace the latest-generation lens care solutions. Ever cognizant of dryness, manufacturers continually engineer these products with an eye toward minimizing dryness and improving end-of-day comfort.
Finally, we must be vigilant in identifying the most compatible lens material for each patient. While much easier said than done, we can achieve this by taking a systematic approach in employing all material platforms, including evaporation-resistant hydrogels, silicone hydrogels and moisture-enhancing daily disposables.
As the contact lens-wearing population grows there is one certainty: dryness will always be a challenge. However, as newer technologies emerge we are continually better able to address the needs of this demographic.
So, stay abreast of the literature, explore all options and embrace newer technologies. You – and your patients – will be glad you did.