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Educate patients about lens care regimen
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I’m sure many of you remember the cinematic thriller, “Jaws.” This 1970s epic spawned a number of sequels, each promising to be more engaging than its prequel. In fact, it was “Jaws 3” that lured moviegoers to the theater with the tagline “Just when you thought it was safe to go back in the water again … ”
As contact lens clinicians we all, to a certain degree, wonder if it’ll ever be safe to go back in the water again. No sooner did we recover from the Fusarium outbreak, than we find ourselves reeling from an Acanthamoeba outbreak. To complicate matters, we must now navigate these Fusarium- and Acanthamoeba-infested waters with two fewer lens care products. Not a reassuring scenario, for sure.
While these atypical keratitis outbreaks have created anxiety among solution manufacturers, eye care providers and patients alike, they have also produced many questions. Are these infections the sole result of specific lens care product deficiencies? Could our quest for enhanced solution “comfort” be yielding formulas with diminished disinfection efficacy? Are our marketing messages – promising the simplicity of “no rub” – actually engendering noncompliance? Have clinicians been lulled into a false sense of security, no longer emphasizing the importance of scrupulous lens care habits? The answer is, of course, an ambiguous yes.
As I see it, this extremely complex equation can be reduced to three variables: patient, clinician and manufacturer. As it is an oversimplification to implicate any one variable alone, it is essential we manage each as well as possible.
It is also prudent to view patients as the “wild card” in this equation. While patients generally want to do the right thing, their behaviors do not always follow. They do not always adhere to good lens hygiene practices, are easily swayed by economic incentives to purchase different products at retail and routinely subject themselves to environmental exposures (such as pools, hot tubs, poorly chlorinated municipal water supplies, etc.). It is for these reasons we must optimize the remaining variables.
For decades, manufacturers have provided us with innovative lens care products, and I’m confident they will continue to do so. However, lens care “chemistry” is extremely complex, and advances come slowly – measured in years rather than months. While we wait for these new products to take shape, clinicians must make every effort to optimize lens care.
To do so effectively means returning to the basics. It means educating our patients regarding “at-risk” environments, hand hygiene and the importance of complying with care product instructions in detail. It means properly maintaining and replacing storage cases. It means strongly prescribing a particular lens care solution – and providing patients with sound rationale for doing so. Perhaps most importantly, it means repetition. Patients need to hear a clear, consistent message at each and every visit. And this message must come from us.
There is actually an upside to this whole saga. It is the fact that the industry, as a whole, has responded so favorably. Our actions have been swift, cooperative and always with the public’s best interest in mind. Anything less, and we’ll never go back in the water again.