According to an investigation in the November issue of Optometry and Vision Science, official journal of the American Academy of Optometry, the majority of individuals who wear contact lenses believe that they are following standard guidelines for lens wear and care, however, in reality only a tiny minority of these individuals actually follow all recommended care steps. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The novel investigation by Dr. Danielle M. Robertson, and Dr H. Dwight Cavanagh, of The University of Texas Southwestern Medical Center, Dallas, indicates that a “significant proportion” of individuals who wear contacts are not compliant with the recommended care steps, although they are aware that doing so increases their risk of complications.

The team examined contact lens knowledge of complications and care practices as well as risk factors in two groups of contact wearing individuals: 152 patients seen at a university eye clinic, and 281 patients visiting a random sample of eye care practitioners in the Dallas-Fort Worth area.

58% of patients in the general community care could name a complication associated to contact lens wear, and 91% of those seen at the university clinic. The most prevalent complications named were those associated to lens comfort/handling and infections.

Although there were only slight differences in contact lens-related complications between the two groups, differences in perceptions and knowledge between the groups most likely reflected the greater rate of considerable eye problems among individuals in the university group.

The majority of individuals were able to identify vital risk factors for lens-related complications. These risk factors include:

  • “topping off” instead of replacing contact lens solution
  • exposing lenses to tap water, including wearing lenses while in the shower
  • and poor hygiene practice

Drs Robertson and Cavanagh explain:

“Overall, 85 percent of patients perceived themselves as compliant with their lens wear and care practices.”

The team used a standard model in order to find out patients’ real level of compliance with recommended care steps and found that only 2% of patients were rated good in this model.

The authors wrote:

“The average contact lens wearer only performed 50 percent of the recommended behaviors,” the authors revealed.

Only one patient was “fully compliant”: a rate of 0.4%. Drs. Robertson and Cavanagh highlight:

“While most patients consider themselves to be complying with standard practitioner guidelines for lens wear and care practices, essentially all contact lens wearing patients exhibit behavioral non-compliance with resulting increased risk for significant complications.”

Given that the majority of contact lens wearing patients knew the risk factors for complications, very few followed the advised care steps, “Awareness of risk alone is not a driving factor establishing compliant behavior,” the investigators note. For eye care practitioners, failure to be compliant with recommendations is a “persistent clinical problem”. Even though this study and prior investigations reported low compliance rates, rates of severe complications connected with contact lens wear are relatively low.

The researchers conclude that as patients are already aware that the risk of complications is increased by not following recommended lens care, additional education will not likely lead to long-term changes in behavior. “New strategies and approaches to effectively modify inherent patient non-compliance are urgently needed.”

Written by Grace Rattue