Non-Compliance with Contact Lens Wear and Care Practices: A Comparative Analysis

Abstract

To compare the effects of existing patient awareness of lens-related complications and underlying risk factors on actual patient behavior during contact lens wear and care practices in two different clinical study populations. Established contact lens wearers (n=281) completed an anonymous written questionnaire upon presenting to their habitual eye care practitioner in the Dallas-Fort Worth (DFW) metroplex. Data were analyzed and compared against a second study population which was comprised of established contact lens wearers (n=152) who were sequentially evaluated following their routine contact lens examination at the University of Texas Southwestern Medical Center at Dallas, TX (UTSW). All patients were questioned regarding his or her lens care practices and knowledge of complications and risk factors associated with contact lens wear. 58% of patients in the general community could identify by name a complication associated with lens wear compared to 91% within the medical center. The most frequent complications reported were related to comfort and handling (72%, DFW) and infection (47%, UTSW). The majority of patients could correctly identify risk factors associated with lens-related complications; awareness for topping-off solutions, tap water exposure, and hygiene varied between groups. Overall, 85% of patients perceived themselves as compliant with their lens wear and care practices. Using a standard scoring model to determine actual compliance, 2% of patients demonstrated good compliance; however, only 0.4% of patients were fully compliant with contact lens wear and care practices. The data reveals some study bias in complication and risk awareness between populations; however, despite this limitation, a significant proportion of patients exhibited actual non-compliant behavior despite acknowledged awareness of risk. 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.