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Use of improved lens technology still requires careful patient evaluation
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Have you ever noticed how certain scenarios can be perceived in two entirely different lights? Consider, for instance, the following familiar example.
A longstanding contact lens wearer laments that his or her contact lenses are no longer comfortable. They articulate symptoms of dryness, redness, irritation and reduced wearing time. Being proactive, you initiate a discussion on silicone hydrogels (SiHys). As you extol their benefits – impressive oxygen transmission profiles, protein resistance, good mobility and dehydration resistance – it is apparent the concept resonates well with your patient.
Eagerly, the patient asks to try a pair, and you agree. This is the moment in which you realize that the two of you probably have different ideas of what is about to transpire.
From a patient’s perspective, the decision to try SiHy lenses is obvious, with no perceived downside. Just get a pair of lenses and go. In some respect, this simplistic view is understandable. After all, if SiHys are a newer, better technology, then why is follow-up even necessary?
We, of course, see it in a completely different light. We view this technology “upgrade” as requiring evaluation, follow-up and, on occasion, multiple lens designs. Herein is the disparity – two diametrically opposed, yet viable, points of view.
Fortunately, the solution is fairly simple. We must provide a clear, rational explanation of why such services are necessary. Our primary responsibility lies in safeguarding patients’ vision and ocular health. In the case of a contact lens technology upgrade, this involves more than just a pair of diagnostic lenses. It requires knowledge, guidance and oversight.
SiHy lenses are no exception to this rule, as they are only as good as the professional efforts in prescribing them. SiHy lenses are characterized by a higher modulus, an attribute that ensures more consistent on-eye mobility. However, this very feature requires an attentive prescribing approach for optimal patient adaptation and comfort.
Likewise, the more sophisticated polymer composition of SiHys places a premium on lens care. Professional recommendations regarding solutions and lens care compliance become even more critical. While SiHy-associated complications are rare, conditions such as papillary conjunctivitis and infiltrative keratitis can occur. For this reason, we must be vigilant in our follow-up, especially for those in continuous wear.
SiHy lenses have proven to be an exceptional addition to our prescribing armamentarium. With multifocal and toric SiHy options now available, they are an even more appealing option.
However, as with any new medical technology, we must also appreciate the subtleties and complexities of SiHy lenses. Presented in this fashion, our patients can better understand the need for professional follow-up as well as strict compliance with lens wear and care. This, no doubt, is the first step toward a happier and healthier contact lens wearer.