BCLA CLEAR - Evidence-based contact lens practice

BCLA CLEAR - Contact lens complications

“…The treatment plan for each patient should be staged according to the severity of the disease. Regular and complete blinking exercises may be recommended to enhance tear film stability [375] and regular after-care visits should afford proper management of the condition and to improve ocular comfort during contact lens wear [376] (CLEAR Evidence-based Practice Report [377].…”

Contact Lens Evidence-Based Academic Reports (CLEAR)

“…Evidence-based practice can be defined as the "conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients" [16]. It involves integrating the best available, clinically relevant, scientific research evidence with a clinician's expertise and an individual patient's values and environment (see CLEAR Evidence-based Practice Report) [14]. Evaluating scientific research findings and using them to make the best clinical decision for patients is a key aim of all evidence-based practice, including fitting and managing contact lenses.…”

“…Evaluating scientific research findings and using them to make the best clinical decision for patients is a key aim of all evidence-based practice, including fitting and managing contact lenses. The quality of research evidence generally comes from the study design [14]. Formal risk of bias tools also exist to assist clinicians with appraising the quality of an individual study rather than simply relying on the evidence level [17].…”

“…Individual studies within a given level of the hierarchy level (such as randomised controlled trials) may differ in their 'quality', due to differences in their study design, tests performed, cohort selection and participant numbers. Some contact lens research employs study designs that are not explicitly described in hierarchical models of research quality or common in general medicine; these include cross-over, contralateral and monadic designs which are often used to understand the clinical performance of different lenses and care products [14]. While systems for rating the level of evidence of individual papers or hypotheses have been developed, they are not robust enough to systematically apply [21], hence the approach taken in CLEAR is to present summaries of the research findings and to critically appraise the evidence on relevant topics.…”

Times they are a-changin for contact lens practice

“…One of the groups to be categorised as lower priority would certainly be the routine contact lens aftercare patients, especially those that were asymptomatic. The recent Contact Lens Evidence-Based Academic Reports (CLEAR) reported the latest information in all aspects of contact lenses [23] but in the report that dealt with contact lens practice there is little current evidence related to the frequency of aftercare [24]. Only one paper suggests the safe aftercare interval and recommends a minimum period of 24 months for soft daily disposable, every 12 months for soft daily reusable and rigid daily wear, and every 6 months for soft and rigid overnight wear, with the proviso that these periods may need shortening if refractive changes are predicted, such as progressive myopia or advancing presbyopia [25].…”