Patient – practitioner communication and contact lens compliance during a prolonged COVID-19 lockdown

Abstract

Purpose Ocular manifestations and ocular transmission of SARS-CoV-2 in contact lens (CL) wearers may be fostered by non-compliance with care and maintenance instructions which, in turn, may be aggravated by inadequate patient-practitioner communication. The purpose of this research was to determine CL use, compliance and patient-practitioner communication during a 3-month long COVID-19 lockdown in Spain. Methods An online survey (developed using Google Forms) retrospectively evaluated CL compliance during the 3-month lockdown (responses captured between 15th July and 10th August, 2020), with particular emphasis on patient-practitioner communication, handwashing practices and CL case hygiene and replacement. Results A total of 247 responses were collected and analysed. Most participants used monthly replacement soft lenses (64.8%) and multipurpose solutions (75.7%), with 86.6% of them owning a storage case for their lenses. During lockdown, a significant percentage of participants ceased lens wear (28.4%) or reduced wearing time (49.2%). Regarding patient-practitioner communication, 54.3% of respondents received specific instructions, mostly about handwashing (93.3%) and storage case hygiene (48.5%). The most frequent non-compliant practices were inadequate handwashing (36.4%), and overextending monthly or two-weekly replacement lenses (35.2%). Many respondents never cleaned (23.0%) nor replaced (16.3%) their storage case, and 27.8% of them reported not having been informed about case hygiene by their practitioners. Conclusion Contact lens compliance, particularly in terms of handwashing and storage case hygiene, was poor during a prolonged COVID-19 lockdown, thus stressing the need to foster patient-practitioner communication strategies to curtail the possibility of ocular transmission and the risk of virus tropism.

The impact of COVID-19 on soft contact lens wear in established European and US markets

“…Most individuals were simply leaving home less often, which minimised the need to wear contact lenses. The findings are generally consistent with previous reports undertaken earlier in the pandemic, in the UK, Ireland, Spain, Portugal, Greece and Jordan where a decline in social interactions and activities/leaving home were also cited as common reasons for decreasing lens wear [16] , [21] , [22] , [23] , [24] , [25] , [20] . Secondary concerns, however, differ both within the cohort investigated and more widely.…”

Ocular manifestations of COVID-19

“…During a lengthy COVID-19 lockdown, contact lens compliance was low, particularly in terms of handwashing and storage case cleanliness, emphasizing the necessity for patient–practitioner communication methods to reduce the risk of ocular transmission and viral tropism. 51 Despite the fact that the influence of eye allergy on everyday activities and emotions was limited, the influence of eye allergy symptoms during the quarantine period was determined to be considerable. 52 …”

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

“…Reports on compliance with instructions about care and maintenance of contact lenses and their accessories reveal levels of noncompliance ranging from 40 to 91%, depending on factors such as study sample, modality of lens wear, and care regime 22–25 . Besides, it is not uncommon for those patients showing good compliance with their contact lens care to claim unawareness of the correct procedures or even of the actual need to clean and replace their storage cases 24,26,27 . These different behaviors regarding contact lens and storage case compliance support the relevance of fluent patient-practitioner communication and unambiguous patient education, which may be hindered by conflicting recommendations and guidelines about storage case care provided by manufacturers, health agencies, and optometrists 28–30 …”

“…[22][23][24][25] Besides, it is not uncommon for those patients showing good compliance with their contact lens care to claim unawareness of the correct procedures or even of the actual need to clean and replace their storage cases. 24,26,27 These different behaviors regarding contact lens and storage case compliance support the relevance of fluent patient-practitioner communication and unambiguous patient education, which may be hindered by conflicting recommendations and guidelines about storage case care provided by manufacturers, health agencies, and optometrists. [28][29][30] In view of the relevance of adequate contact lens storage case maintenance and replacement and of the evidence of pathogen tropism from contaminated hands and contact lens cases to the ocular surface, thus increasing the opportunity for infection, strategies to improve compliance with care of contact lens accessories need to be explored and implemented.…”