contacts

Offer Part-Time Contact-Lens Wear

Modern disposable soft lenses make wearing contact lenses for specific situations easy.

MELISSA VIKER, O.D., Eden Prairie, Minn.

Although many contact-lens wearers have a pair of backup spectacles, we often don't think that spectacle-wearers should have a backup stock of contact lenses. Perhaps this attitude remains from the days when contact lenses were more expensive and harder to adapt to than spectacles and, therefore, not something one would do "on the side." But, modern disposable soft lenses make it much easier for patients to wear contact lenses for specific situations, even if these patients can't or don't want to wear them full-time.

Here, we look at four patient populations that can benefit from disposable contact lenses.

Children or adolescent patients

If the child or his parent(s) are hesitant about contact lenses, part-time contact-lens wear via a disposable modality is an excellent option. This is because it's a great way to ease into contact-lens wear without the pressure of a major commitment.

For instance, I recently saw an 11-year-old astigmatic boy who played multiple sports, such as baseball. Although, he said he could see fine with his spectacles, his active lifestyle caused him to constantly lose or damage his glasses. As a result, his parents expressed an interest in contact-lens wear for their son, though also confessed a concern about whether he was mature enough to comply with the required lens wear and care.

I often recommend single-use lenses for these cases, but since this patient had astigmatism, I fit him with a one to two-week disposable, that he could wear solely for sports. (See "Disposable Lenses," right.) The end result: The patient was able to prove to his parents that he could care for these lenses, so they allowed full-time wear.

I find this is often the case with pre-teen patients. My theory: I think this set of patients is compliant because they've not yet hit those rebellious years of questioning authority. Therefore, they're still attentive to the specific directions of authority figures.

Further, I've found that most of these patients learn insertion and removal very quickly. In fact, the Contact Lens in Pediatrics (CLIP) study, showed that both children and teens can adapt to contact-lens wear and derive similar benefits to that of the afore-mentioned 11-year-old. The study, published in the September issue of Optometry and Vision Science, compared contact-lens fitting and follow-up between eight- to 12-year-olds and 13- to 17-year-olds.

Stay-at-home moms

Another group of patients who can be very successful with part-time wear are stay-at-home moms whose children have grown up enough to give them the freedom to re-enter the workforce either full- or part time, be social again (dine with friends, etc.) and exercise.

As a result of expense, dryness and/or the inconvenience of caring for contacts, many moms have sacrificed contact-lens wear.

I offer these patients the option of daily-disposable lenses, as they allow this busy patient population to wear lenses in situations they'd rather not be wearing spectacles, such as at work.

When wearing daily disposable lenses, no additional time is added for the care regimen. Caring for children and balancing outside interests is tricky, so these patients really appreciate the availability of daily-disposable lenses.

In addition, I've found that this patient population is often looking for ways to reinvent themselves. In fact, consider this: The Americans' Attitudes & Perceptions about Vision Care Survey, conducted last year by Harris Interactive on behalf of The Vision Care Institute, a Johnson & Johnson Company, found that 32% to 50% of people were dissatisfied or only moderately satisfied with the prescription eyeglasses they wore most frequently. Further, a large majority (85%) of contact-lens wearers said they felt more attractive in their contact lenses. In addition, those who didn't wear their contact lenses all the time said they were most likely to wear them on special occasions (38%), going out (38%) and for sports activity/exercise (30%). I've certainly found this to be true with my part-time wearers. (A total of 3,716 people participated in the survey, with 47% of participants male and 53% of participants female.)

Presbyopic patients

The Harris poll also revealed that people younger than age 40 are far more likely to wear both prescription glasses and contact lenses, and only 5% of respondents older than age 40 reported wearing both contact lenses and spectacles. I suspect that the most popular reason for this is that these patients don't see the sense in wearing contact lenses if they have to wear glasses for reading.

Your job: Inquire about the patient's lifestyle by asking questions, such as "Do you have any hobbies," to determine whether a disposable lens could increase their enjoyment of a particular activity. If this is indeed the case — and it usually is — you'll be able to show the patient the freedom he will gain by wearing contact lenses.

For instance, "Bob," a 50-year-old male with -4.00D of myopia told me he discontinued contact-lens wear 10 years ago because his development of presbyopia warranted spectacle-wear for reading. He was also experiencing dryness in his contact lenses when wearing them all day in front of his computer. He further said that he didn't mind his spectacles, except on winter weekends, when snowmobiling. He reported that his glasses didn't fit well under his helmet, and they tended to steam up, but that he couldn't drive his snow mobile safely without them.

When I told Bob that contact lenses were available for occasional use and that they might work well for snowmobiling, he expressed an immediate interest in them. So, I fit him in a oneday daily disposable for his myopia.

Bob inserts these lenses before snowmobiling and throws them away at the end of the ride. He's since told me that he's absolutely thrilled with how much more comfortable and enjoyable his snowmobiling is.

Because snowmobiling is a common past time in the Minneapolis area, I've fit many patients like Bob. In addition, I've fit presbyopic patients in disposable lenses for other recreational activities, such as motorcycling and golf.

Patients who experience dryness

I've found that patients who've experienced significant dryness and discomfort with prior contact-lens use can often achieve success with disposable lenses. This is because these lenses require limited wearing time and are made with healthy new materials that have a better wetting angle, adding to the comfort of the lenses. I usually start these patients with hydrogen-peroxide systems instead of multipurpose solutions to further increase comfort.

When Sue, age 32, entered my office, she said she was very upset because her boss had recently moved her to the night shift, and she was having considerable discomfort with her contact lenses. She told me she wasn't willing to give up contact-lens wear for work or socially. So, I switched her to a two-week disposable low "wetting angle" silicone-hydrogel lens. She has since reported being much more comfortable wearing her contact lenses during both work and her time off.

Lens modalities and considerations

I've found that the one-day or single-use modality is a great option for any part-time wearer because it cuts down on lens maintenance, which improves compliance. Further, I've discovered that parents of pre-teens and teenagers find the simplicity and safety of this modality appealing, as these lenses require no upkeep and little wearing time.

Also, my adult patients who were former lens wearers and recall paying several hundred dollars for lenses have told me that they find the price of single-use lenses very reasonable, especially for occasional wear.

Most of my middle-aged patients who wear lenses part-time wear them for distance activities, so their presbyopia usually doesn't play a role in their lens choice. If, however, these patients express an interest in wearing a lens for reading, or they have astigmatism, I educate them about lens options that fall outside the one-day modalities, such as weekly disposable lenses and, in some cases, monthly options.

Practice impact

Researchers at the London Business School found that, on average, contact-lens patients are 60% more profitable than spectacle patients, as they return for more visits and are more likely to make dual purchases of spectacles and contact lenses.

I mention contact lenses to almost every patient, as I truly believe this modality can improve the quality of life for many of them.

I find that if you take the time to ask the patient about his hobbies and work environment, there's almost always a lens from which he can benefit.

And, because I've been able to enhance the enjoyment of my patient's activities by inquiring about his lifestyle, he knows I have a genuine interest in his well-being. This has not only made my patients fiercely loyal, but has inspired several referrals. OM

Dr. Viker practices in Eden Prairie, Minn., and specializes in primary-care optometry with a contact lens emphasis. E-mail her msviker@comcast.net.