Soft contact lens use teaching methods vary globally
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Key takeaways:
- Most patients were taught to hold their upper eyelashes with one hand and pull the lower eyelid down with the hand holding the lens.
- Sixty-two percent of participants did not use instructional videos.
A variety of approaches were used to teach new patients how to handle soft contact lenses, although most instructors dispensed lenses after watching patients succeed three times, according to survey data in Contact Lens & Anterior Eye.
“All neophyte contact lens wearers require training on how to handle contact lenses. Currently, almost no published information exists describing the most common approaches used by those involved in such training in soft contact lens wearers,” Marta Vianya-Estopa, PhD, associate professor at the Vision and Hearing Sciences Research Center at Anglia Ruskin University in the United Kingdom, and colleagues wrote. “This study aimed to gather information on the approaches taken by those conducting this training worldwide.”
Researchers sent out a 20-question survey about methods optometry clinics use to instruct new contact wearers on handling soft contact lenses, including techniques for applying and removing lenses, which staff members conducted teaching appointments, the duration of the appointments and whether they use instructional videos.
The survey was available in English and Spanish, and responses were collected from May 2021 to April 2022.
The researchers received 511 complete surveys. Responses came from 31 countries, with 48.7% from the U.K., followed by 22.9% from Spain.
Teaching appointments typically lasted about 30 minutes and were conducted by optometrists (53.2%), optical assistants (24.3%) and contact lens opticians (11.9%).
The most common method for lens application was holding the upper eyelashes with one hand (84.7%) while holding the lower eyelid down with the same hand holding the lens (89.4%). Most patients were taught to apply the lens directly to the cornea (57.7), whereas others were taught to apply the lens to the temporal conjunctiva (21.5%) or inferior conjunctiva (19.9%).
To get the lens to settle, respondents taught patients to move their eye around while holding their eyelids (53.2%) and to slowly release the eyelids while looking down (40.7%).
To remove the lenses, 75% of respondents taught patients to hold their eyelids the same way as for lens application. Most told patients to drag the lens down and pinch inferiorly (49.3%), but others recommended dragging the lens temporally before pinching (27.2%) or pinching the lens directly off the cornea (21.5%).
Sixty-two percent of participants did not use videos during the appointment.
Most respondents (77.9%) reported dispensing contact lenses to the patients after watching them successfully apply and remove the lenses two or three times.
When asked to rate the success of teach appointments on a scale of 0 to 100, with 100 meaning their teaching always works, 63.7% of respondents outside the U.K. and 42.1% of respondents in the U.K. gave themselves a score of 90 or higher.
“This survey has provided information on the diversity of teaching approaches used for soft contact lens application and removal training around the world,” researchers wrote. “The study provides valuable insights for eye care practitioners involved or delegating the task of contact lens handling and care training, highlighting the need for further research in this area and facilitating the development of evidence-based guidelines and best practices for contact lens education.”
Perspective
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This study by Vianya-Estopa and colleagues informs clinicians of the various soft contact lens handling techniques, including holding upper eyelashes and applying lenses directly onto the cornea, used in the U.K., Spain and other countries to provide individualized patient application and removal training.
Surprisingly, most respondents do not use videos to aid in application and removal training, which may ease patients into the process and cut down on time. It also was surprising to see approximately 22% of respondents teach patients to pinch the lens directly off the cornea, which is risky for epithelial defects, especially for patients with poor lens fit and lens binding.
It is important for clinicians to know the various contact lens handling techniques and provide application and removal training based on each patient’s age, dexterity and comfort.
The limitations of this study include having most respondents in the U.K. and Spain. Also, the survey did not categorize the various techniques used by age — for example, eyelids held or not during lens application — and did not correlate patient contact lens dropout rates with using videos and extra training sessions.
Studies examining global soft contact lens handling techniques, dropout rate and video usage are warranted for enhancing soft contact lens success rate.
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