Use these tips to overcome patient objections to daily disposable lenses
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The No. 1 thing I hear from patients — whether they are first-time or established contact lens wearers — is that they want lenses they can comfortably wear all day.
After that, priorities include convenience and flexibility, or the option to wear contact lenses for some situations and glasses in others. As clinicians, we have many excellent contact lens products to choose from. I try to select the best option to meet the patient’s vision and lifestyle needs.
I typically recommend a daily disposable lens as a first option for patients, because I find this modality to be the most comfortable and the most convenient. It also offers that flexibility for occasional wear without compromising safety, because you don’t have to worry that lenses will be sitting in ineffective solution for a week between uses.
One recent patient was a 50-year-old male actor who travels and spends a lot of time outdoors. He had been wearing reusable contact lenses but didn’t like them very much, for a host of reasons. He was presbyopic, so we needed to consider something that could provide clarity for multiple focal distances. And lastly, we needed to address the difficulty he was having inserting the contact lens in his left eye because he is right-hand dominant.
I fit him in a new daily disposable lens that is a great option for comfort for long workdays and has UV protection to add an extra level of sun protection outdoors. The daily disposable modality is a great choice for frequent travelers because they don’t have to worry about contact lens cases and solutions. The pupil-optimized multifocal design of the lens in which I fit him corrects for the patient’s refractive error and age, providing what I find to be excellent optics, especially at intermediate distances.
This patient, like so many of our patients, spent much of his day on devices. I was concerned that if he experienced compromise in clarity at the intermediate distance, he would not like the lenses. Finally, we helped him improve his lens insertion technique so he was more confident putting his contact lenses on.
Insertion tips, tricks
Although we tend to think of insertion and removal training as being something that only children or first-time wearers need, I actually find that a lot of adult contact lens wearers were never properly taught these techniques. They may be struggling but embarrassed to say so. The biggest challenge to overcome with adults is they get frustrated more quickly than children and tend to give up. But that wasn’t the case for this patient, who was able to successfully insert the lens on the first try, with just a few simple tips.
Over the years, I have found that these tips really resonate with patients and help them succeed more quickly:
- Hold the upper lashes open rather than the eyelids, “pinning” the lashes to the brow bone. This provides more resistance to our eyes’ very strong blink reflex, creating more surface area to put the contact lens in.
- When holding the lashes open, keep the fingers as close to the lash base as possible to provide further leverage against the blink reflex.
- Look side to side and up and down once the contact lens is in the eye. That movement of the eye under the lens will smooth out any bubbles in the lens and help it center more easily.
I also email patients a link to Lens Assist, an Acuvue-branded website with videos of insertion and removal. Although there are plenty of videos available on YouTube, it can also send patients down a rabbit hole of questionable advice, and you can’t predict what they will actually see.
With patients who have been prescribed toric contact lenses, it is important to spend a little extra time during insertion and removal training to educate the patient about astigmatism, so they understand that toric lenses fit a little differently and require a few minutes to settle on the eye. We talk about the sensation of decentration and recommend looking up at the ceiling and blinking several times if they feel like their lenses are decentered.
Address discomfort
With established wearers who are struggling with comfort, or those who gave up on contact lens wear due to discomfort, it is important to consider the underlying reasons for that discomfort. If the patient has dry eye or a poor quality tear film, independent of contact lens wear, I might consider a prescription for anti-inflammatory agents, immunomodulators or in-office dry eye treatments.
We can also explore switching contact lens brands or materials. Each manufacturer has particular wetting agents and material properties, and some patients may just be more sensitive to one product over another.
And, of course, more frequent replacement is another strategy to improve comfort and wettability. I see a lot of patients who have been wearing monthly lenses for years but have gradually found that they can’t tolerate the lenses for as long as they would like to wear them. In most cases, they have never even been made aware of daily disposable options. In this situation, I give them a sample strip of a daily disposable lens by the same manufacturer to see if their comfort level improves.
Some people are resistant to change, so being able to tell the patient, “This is the same manufacturer, just a different replacement schedule,” makes the change a little bit less intimidating. I tell them we can stick with their previous lens if they don’t see any difference in comfort.
Some patients have objections to daily disposable lenses, most often due to the cost but also for environmental reasons, because they prefer to reuse rather than throw away. In such cases, I might move a patient who is struggling with comfort from a monthly lens into a 2-week lens, because the cost is similar, but doubling the replacement frequency will almost always improve comfort.
We really can’t ignore cost considerations or resent that a patient doesn’t follow our professional guidance about the “best” option. Even though I think daily disposable lenses are ideal, I also know that if I just prescribe them without the patient’s buy-in, they are likely to just go to an online service and order their old lenses. Involving the patient in the decision and tying the benefits of the new lens to the patient’s lifestyle and current struggles is the best way to ensure success with a new modality.
Reference:
- Acuvue LensAssist. https://www.acuvue.com/en-us/lensassist/. Accessed Feb. 27, 2024.
For more information:
Danielle Richardson, OD, is a glaucoma certified therapeutic optometrist, currently practicing at Zak in Los Angeles. She specializes in LASIK surgery comanagement, contact lenses, dry eye and digital eye strain.
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