By Jon Scott Walker, OD, MS, FAAO
In contact lens wear, discomfort leads to costly dropouts—and daily replacement lenses are an effective tool to ensure comfort and retain patients.
Contact lenses feel best when they are fresh from the blister pack. Knowing how highly patients value the comfort of a fresh lens, my practice works to get as many patients as possible into daily replacement lenses. We have discovered that fresh lenses are a key to both patient comfort and practice success.
Contact lens patients are highly valuable to a practice. They return for office visits more frequently than eyeglasses-only patients, which adds up to more professional fees over time. The key is to keep patients healthy and comfortable in their contact lenses, to avoid the leading cause of dropouts: discomfort. In fact, the loss of a single contact lens patient may cost your practice up to $24,000 over the patient’s lifetime, 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.
Last year, our multi-location practice made it a goal to put 60 percent of our eligible patients into daily-replacement contact lenses. Of our 10 offices, two already have over 50 percent of contact lens wearing patients in daily replacement lenses. When daily replacement lenses are not available in a patient’s prescription, we opt for a two-week replacement cycle whenever possible. We believe that a shorter replacement cycle positively impacts the overall patient experience.
Here are the benefits provided by daily-replacement contact lenses:
Limit Deposition
Proteins, lipids, mucins and other components of tear film begin to deposit on contact lenses within minutes of lens insertion. While these components serve many beneficial functions when dissolved in the tears, their interactions with contact lenses are not always advantageous. In the tear film, proteins such as lysozyme, lipocalin and lactoferrin protect the eye from infection. But once deposited on a contact lens, these proteins can denature, losing their antimicrobial functions and becoming irritants.
In addition to causing irritation and inflammation, denatured protein deposits can reduce visual acuity. Over time, increasing deposits–of proteins, lipids and external chemicals–reduce comfort and may even put the eye at increased risk of infections such as microbial keratitis. And while multipurpose disinfecting solutions do an acceptable job of cleaning and disinfecting, they can’t restore a lens to its unworn state.
More Comfortable, More Compliant
Even those patients who are compliant with their cleaning regimens can experience discomfort from worn lenses over time. Patients in daily replacement lenses not only have the experience of a fresh lens each day, but they also are significantly more compliant with practitioner prescriptions for wearing schedule.
Ask Patients Specific Questions About Comfort
About 50 percent of US patients who discontinue contact lens wear do so because of discomfort. We should remember this when patients report that their contact lenses feel “fine.” It is essential to talk specifically–and to listen carefully–to our patients about their comfort in contact lenses across the wearing cycle. Talking with patients about how their comfort level changes as wear time increases can help them understand the benefits of more frequent replacement.
I ask all my patients: “If you could change one thing about the contact lenses I prescribed to you last year, what would it be?” This is a great leading question that also ties in your “prescription.” Identifying and addressing discomfort helps to build patient relationships. Without this attention, uncomfortable patients might not only drop out of contact lenses, but also try a new practice for their next annual examination.
Give Patients a Chance to Experience Comfort
I find that patients respond well to experiencing different contact lens modalities. When introducing the option of daily replacement lenses, I give them a five- or 10-day trial supply. This allows them enough time to appreciate the difference in convenience and comfort level. After several days, the overwhelming majority of my patients say they agree–fresh is best.
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More Frequent Replacement Makes for Long-Term Contact Lens Patients
Keep Contact Lens Patients Comfortable in Their Lenses…and Keep Them in Your Practice
Jon Scott Walker, OD, MS, FAAO, practices in Jacksonville, Fla. He is an occasional speaker for VISTAKON, a Division of Johnson & Johnson Vision Care. To contact him: jwalker1od@comcast.net
