Compliance versus Risk Awareness with Contact Lens Storage Case Hygiene and Replacement

Abstract

SIGNIFICANCECompliance with hygiene and replacement of contact lens (CL) storage cases is key to avoid CL contamination and anterior ocular surface complications. However, compliance levels with these accessories remain low, even in patients with awareness of the risk associated with noncompliance.PURPOSEThis study aimed to determine level of compliance with common practices regarding CL storage case hygiene and replacement, type of information provided by practitioners, and risk perception.METHODSAn ad hoc self-reported survey was used to collect demographic and CL wear details, compliance with storage case care, type of received information, and risk perception (in a 1-to-5 scale). Inferential statistics explored the relationship of demographic details and type of received information with compliance and risk perception.RESULTSNondaily disposable wearing participants returned 299 completed surveys, with a median age of 24 years (76.9% females). Monthly replacement silicone hydrogel CLs and multipurpose solutions were predominant. Self-reported compliance with storage case care was poor, with 19.1% of respondents never cleaning their cases, 68.6% exposing them to tap water, and 26.4% failing to replace them within 6 months of acquisition. Two-thirds of respondents received specific information on case maintenance, mainly in oral form. Perceived risk associated with poor-compliance practices was high (median values of 4 and 5), and increased with educational level (P = .02, regarding handwashing; P = .03, regarding case hygiene), with years of CL wear experience (P < .001, regarding handwashing), in those patients provided with specific information on CL case care (P = .01, regarding case replacement).CONCLUSIONSCompliance with CL storage case hygiene and replacement was generally poor, although awareness of risk associated with noncompliance was high and influenced by factors related to demographic details, CL experience, and patient-practitioner communication. Strategies must be explored to increase risk awareness through education because this may lead to better compliance practices.

Are Patients Sufficiently Informed about Contact Lens Wear and Care?

“…[7][8][9] Habitual malpractices include poor hand hygiene, use of tap water, sleeping with or reusing daily disposable contact lenses, and extending replacement intervals of both contact lenses and accessories. 8,[10][11][12][13][14] Although causes for noncompliance are largely unknown, age, wearing experience, and socioeconomic status have all been documented by previous authors. 9 Fluent communication is essential in all facets of the patientpractitioner relationship, and it underpins patient compliance.…”

“…20 It also states that communication with patients must be unequivocal and adapted to their level of understanding, and that it should include, if possible, written information regarding contact lens care, wear, and replacement, 21,22 although recent research noted that many patients failed to revise these instructions at home. 13 Similar institutions and regulating bodies in other countries, such as the General Optical Council in the United Kingdom, also recommend visual health providers to consider the needs of their patients when selecting type, use, and replacement of contact lenses, and they stress the relevance of fluent patient-practitioner communication. 23 It was the purpose of this study to determine the type and content of the information licensed optometrists in Spain provide their patients about wear, maintenance, and replacement of contact lenses and their accessories.…”

“…In effect, 28.0% of respondents noted not always instructing their patients on the need to rub contact lenses, 34.3% did not always address contact lens replacement, and 6.8% did not always explain storage case hygiene and replacement; the latter information is seldom provided in writing. These areas have been traditionally associated with patient noncompliance on the one hand, 2,13,24 and with contact lens-related complications or increased risk of microbial contamination on the other. 2,25,26 Overall, information to patients was provided orally only (48.6%) or orally and in written format (43.0%), with only 8.4% of respondents using other strategies such as messaging apps to remind their patients of wear and care instructions.…”

“…[27][28][29] For instance, a recent survey addressed to Spanish wearers revealed that, of those users receiving written instructions, 60.3% never revised these instructions afterward. 13 Other authors have noted that patient anxiety and large volume of simultaneous oral information shared at the initial fitting visit may reduce retention of details, 30 thus encouraging practitioners to provide writing guidance to all patients. 31 This information should be adequate to the literacy and comprehension level of the patients, must be accompanied by abundant photographic and video material, 32 and should add explanations to justify the need for each recommendation.…”

“…The items included in the survey were selected based on previous published studies and on the clinical experience of the authors. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] A preliminary version of the survey was administered in face-to-face format to a convenience sample of nine licensed optometrists, and their comments were used to rewrite approximately one-third of the items for clarity and add response options to two items. The final survey was structured in 5 sections comprising a total of 54 items.…”