PRESCRIBE CONTACT LENSES TO TREAT OCULAR DRYNESS

THERE HAVE been many discussions about determining the differences between contact lens-induced dry eye vs. clinical dry eye. In fact, we have previously discussed it in this column. (See July’s “Contact Lens.”) Here’s a new approach: Instead of focusing on the cause of contact lens-related discomfort, why not look at ways to improve the ocular surface?

It is a small reversal of thought. Here’s what it would look like:

1 SET YOUR EXPECTATIONS

First, assume everyone has some sort of underlying dryness — until proven otherwise. Consider that many of our patients have demanding visual days with the high use of digital devices, just one of the factors contributing to dry eye discomfort. Americans spent about 8 hours and 25 minutes per day using various forms of digital media — TV, smartphone, computer, according to The Nielsen Total Audience Report for the second quarter of 2016. These patients likely have a reduced blink rate, incomplete blinking and intermittent dryness throughout the day.

Second, expect that your patients are going to wear their lenses for long hours during the day. I would not expect someone to take his or her lenses out mid-day or immediately when arriving home from work. That wear time is more than 8 hours.

With this knowledge, look for specific contact lenses that have the potential to enhance the corneal surface, and make this your go-to lens.

2 REPROGRAM YOUR WAYS

With this way of thinking, your first approach is no longer to assume contact lenses are inducing dry eyes when presented with complaints or clinical signs. Continue a step further, and consider that contact lenses can provide a valuable tool, when used correctly, for treating dry eye conditions.

Here are a couple examples of ways this can happen.

1. As a bandage. Bandage contact lenses have the potential to provide a smooth ocular surface over a corneal abrasion. They can help protect the corneal surface during the healing process and allow for faster recovery.
2. As a treatment. Consider whether the cause of your patient’s moderate dry eyes and the condition itself can be improved utilizing one of the contact lenses on the market that have been specifically designed to maintain moisture and wettability throughout the day.

MAKE THE CHANGE

There are ways we can improve the ocular surface, VA and grow our contact lens-wearing population. Perhaps a mere tweak in your thought process will help you unlock one of those ways and increase patient satisfaction at your practice. OM

DR. MILLER is a partner at Eyecare Professionals of Powell, in Powell, Ohio, on the board of the Ohio Optometric Association and is an adjunct faculty member for The Ohio State University College of Optometry. To comment on this article, visit tinyurl.com/OMcomment .