Educate Patients About Hydrogen Peroxide Solutions, Reduce Dropouts

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By Pamela Lowe, OD, FAAO

I strongly prefer daily replacement contact lenses for my patients, but since some of my patients still wear contact lenses requiring a lens care regimen, I needed to find solutions that delivered the best results. For that reason, I recommend a hydrogen peroxide-based solution like Clear Care. I find that patients who are educated by me about the benefits of this type of solution are likely to stay in their lenses long-term and experience high satisfaction with their contacts. Hydrogen peroxide-based solutions are, hands-down, the most effective cleaner for killing any pathogens that can be on the contact lens, the BEST way to reduce solution-related complications since patients are inserting lenses from a sterile solution after disinfection and the best way to increase long-term comfort for greater contact lens wearing success! Here is why and how I educate patients about the value of hydrogen peroxide-based solutions.

Hydrogen Peroxide Solutions Promote Compliance

I find patients who are on hydrogen peroxide- (H2O2) based solutions like Clear Care are more knowledgeable about cleaning their lenses and the importance of compliance with cleaning. H2O2 systems naturally promote compliance since a minimum six-hour cleaning time is essential otherwise the lenses will give a terrible sting from residual H202; because of this, doctors are extra careful to explain the powerful cleaning properties. But since companies marketing solutions stress saline-based products, most patients readily identify with those systems instead.

ID PATIENTS for HYDROGEN PEROXIDE SOLUTIONS

Hydrogen Peroxide Solutions for Those Not in Daily Replacement

I have 2,700+ contact lens wearers; with 65 percent of those in daily replacement and single-use monthly continuous wear which require no solutions. My contact lens philosophy leans heavily toward daily replacement lenses because of the health of replacing lenses daily and no possibility of solution complications or poor hygiene/cleaning habits causing complications. That said, all other soft lens wearers are primarily in a silicone monthly lens requiring a solution, with my top choice for them Clear Care. Since my contact lens practice philosophy is such that taking solutions out of the mix is the healthiest option, H2O2 products are the closest way to mimic taking “solutions out of the mix” since after the solution neutralizes, the patient is taking the lenses out of a gentle saline solution, hence not exposing the eyes to any preservatives or chemical sensitivities.

PRESCRIBE

Prescribe a Branded Lens Care Regimen

We have about a 9-10 percent drop out rate with the national average being 16 percent, according to “New Data on Contact Lens Dropouts: An International Perspective” by John Rumpakis, OD, MBA, a study published by the Review of Optometry in 2010. We “prescribe” vs. “recommend” a patient’s lens care system and are certain to educate the patient that generic solutions are not the SAME (as marketed) as the branded solutions, especially since the generic based solutions, i.e Target Brand, can be a totally different manufacturer solution depending on what company’s solution is the best deal to the vendor at the time. I explain to patients that they may have a sensitivity to a generic solution they are substituting and I will perceive that as a contact lens fit problem and I can be chasing my tail wasting time changing lens material and fit when it can be a solution-related problem. I stress to patients that if they are cleaning lenses they MUST stay with the brand name solution I prescribe. Not only must they stay with the same brand solutions but compliance with proper cleaning and good contact lens case hygiene is essential in cutting down on complications and facilitating comfortable contact lens wear.

I tell patients generics are NOT equal to the brand I prescribe; when it comes to H2O2, Clear Care, hands down, has the best neutralization capacity so there is the least residual H2O2 after the six hours or more of the catalyst disc action.

EXPLAIN

Explain Value of Hydrogen Peroxide Solutions

I tell patients that there is nothing healthier than putting a fresh contact lens on every day, hence that is why we primarily fit daily replacement. BUT, if the patient has high astigmatism, multifocal lenses or overnight needs, then a silicone monthly is the next best option. The strongest, most effective cleaning and disinfection is with hydrogen peroxide, AND since H2O2 neutralizes to a gentle saline solution, it is the best way to “take solutions out of the mix” which is a health benefit of daily replacement. So, since we need to fit with a lens that has to be cleaned, let’s use the most effective cleaner possible.

I tell patients that there is no substitute to the gold standard cleaning of H2O2, and because of their ocular health needs, I am prescribing this special system to give them the healthiest option for contact lens success.

EDUCATE

Educate Need to Following Solution Directions

I explain that the catalyst disc in hydrogen peroxide solutions needs at least six hours to remove an oxygen molecule from H2O2, thus creating a gentle saline solution. I emphasize that they don’t want to experience what H2O2 feels like in the eye, and if they accidently do, they will be VERY motivated to not make that mistake again. We point out the fact that the top of the bottle has a red tip, warning the patient not to put directly in the eye or rinse lens with Clear Care without putting it through the neutralization process. We also warn that if they DO NOT see the familiar “bubbling” immediately after closing the clear case system they must replace the case or clean and rinse the lens with a saline-based system before ever wearing the lenses again.

Explain Importance of Not “Topping” Off Solution

I stress that case hygiene is a must and that reusing any solution is very ineffective for cleaning lenses and can lead to serious complications.

Have Staff Back Up Your Lens Care Recommendations 

Staff being on board with solution-prescribed regimens is essential to a doctor being successful with patient compliance. My staff is well-educated on the key messages needed to make sure patients are educated properly on use of their care system.

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Pamela Lowe, OD, FAAO, is the owner of Professional Eye Care Center in Niles, Ill. To contact her: plowe@proeyecarecenter.com