Issue: October 2018
August 22, 2018
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Report shows disconnect in ECP-patient expectations for 1-day silicone hydrogels

Issue: October 2018
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Michele Andrews, OD
Michele Andrews

A new report from CooperVision shows common misconceptions held by eye care professionals on 1-day silicone hydrogel contact lenses.

“The report shows a gap in patient perspective on 1-day silicone hydrogel lenses and what practitioners assume patients expect,” Michele Andrews, OD, director of professional affairs for North America at CooperVision, told Primary Care Optometry News.

“Consumers know the lenses are available ... they are motivated to learn about them and perhaps try them, and they expect their practitioner to educate them on the different options,” she continued.

Researchers surveyed more than 450 practitioners and 1,500 consumers from three markets: the U.K., U.S. and Japan.

While 1-day silicone hydrogels have been available for about 10 years, only half (52%) of the daily disposable fits recorded in the 2017 international prescribing report used silicone hydrogel materials.

Nine out of 10 eye care practitioners (92%) agreed that 1-day silicone hydrogels lenses are the best choice to safeguard patient eye health related to contact lens wear, and 87% said silicone hydrogels should be the first choice for daily disposables.

However, ECPs identified three barriers to implementing 1-day silicone hydrogel lenses: cost, allergy to silicone and comfort.

Patients want all of the relevant information available to make their choice,” Karen Walsh, BSc(Hons) PGDip, MCOptom, FIACLE, clinical scientist at the Centre for Ocular Research & Education (CORE), told PCON.

“Patients are expecting to have a conversation about cost and they want to have it with their doctor,” Lyndon Jones, OD, FAAO, director at CORE, added. “Consumers do so much research online that ECPs think they’ve already made their decision, but patients don’t have all of the data.”

Lyndon Jones, OD, FAAO
Lyndon Jones

The report highlighted a self-imposed set of barriers from ECPs, particularly surrounding cost. It appears ECPs have greater freedom than many realize to recommend their preferred contact lens, according to the survey.

Silicone allergy as a hindrance to prescribing 1-day silicone hydrogels was a surprise for the researchers, according to Jones.

“A silicone allergy is biologically impossible,” he told PCON.

Jones referred to a recent publication that reviewed the etiology of allergic response and concluded that silicone has none of the properties that would elicit one.

Walsh noted that contact lens complications can mimic allergy, with symptoms such as redness, inflammatory changes and contact-lens induced red eye.

Additionally, daily disposable lenses require no cases or solutions to be used, so there is a higher safety profile in terms of cleaning and storing, she said.

Recent research has shown the infiltrates associated with daily silicone hydrogel lens wear were identical to daily hydrogel lenses, Jones added.

The survey showed that 88% of ECPs agree that 1-day silicone hydrogel lenses provide better long-term wearing comfort than 1-day hydrogel lenses. However, a dichotomy was seen, as the third most common concern among ECPs was that silicone hydrogels were not as comfortable as hydrogel lenses.

“There are no downsides to wearing silicone hydrogel lenses,” Jones said.

Additionally, 25% of the dropout rate is due to contact lens handling, Andrews said.

“With good communication and solid education, there’s no reason patients can’t come back after trying a lens they didn’t like, to get other options from their ECP,” Walsh said.

Jones added that silicone hydrogels are a good choice for first-time wearers, with the thicker modulus making handling easier.

“Knowing what patients want will help lessen practitioners’ hesitancy in this market,” Andrews concluded.

The clinicians added that an educated support staff is also important.

“We found that practitioners clearly understand the benefit of silicone hydrogels. This gives them permission to prescribe the 1-day modality more often,” Walsh said. – by Abigail Sutton

Disclosures: Andrews is employed by CooperVision. Jones is director at CORE. Walsh is clinical scientist at CORE.