Contact lenses have been popular ever since their introduction. Although glasses have a longer track record by a few hundred years, many people find them uncomfortable and lacking in peripheral vision. But contact lenses still elicit a gee-whiz feeling the first time a patient puts them on. The problem has never been that initial patient experience; it’s the need to keep patients happy and safe long term. And two recent reports suggest, once again, that both those aspects of lens wear come up short.
As reported this month in our news section (see News Review), a new study in the journal Ophthalmology shows that LASIK patients had higher satisfaction scores than contact lens wearers. Tellingly, LASIK satisfaction improved over time while contact lens satisfaction declined. Remember, this is for a surgery that costs several thousand dollars, doesn’t always deliver 20/20 results and offers no flexibility to change the Rx as the person’s visual needs change as they age.
Safety concerns—long thought, or at least hoped, to be declining in the daily disposable era—also persist. In August, the Centers for Disease Control and Prevention issued a report on infectious keratitis in contact lens wear from 2005 to 2015 that reveals threats to eye health with this modality. The study linked one million doctor visits annually and 1,075 cases of corneal infection during the 10-year study period to contact lens wear. Nearly 20% of those cases resulted in scarring that reduced vision. And 25% could have been avoided by more responsible patient behavior.
It’s tempting for ODs to see in these numbers a justification to not even bother with contact lenses. Speaking as someone who’s worn soft contact lenses for 27 years, I know their shortcomings first-hand. But I also know—and doctors should remember—that positive feelings accompany every negative one.
Yes, my eyes get sore near the end of the day (but I’ve also had 16 hours of uninterrupted wear). Lens handling and insertion can be a frustrating experience (but that’s because the lenses are so thin that I can wear them safely for so long). Lens cleaning and disinfection is a messy chore (but it kept my costs down before I finally switched to daily disposables). When I accidently wear my lenses overnight, I wake up with blurry vision and sticky eyes (but that’s because the lenses were so well designed that I can afford to sometimes be careless and forget to take them out). And my multifocal contact lenses often perform badly in low light (but they sure are less conspicuous than reading glasses).As you can see, you can tell the story of contact lens wear entirely in positive terms or in negative ones. My advice: tell both stories. Patients need to hear it all. If you oversell the positives, patients will eventually get disappointed—and maybe a little distrustful. If you dwell only on the negatives, you’ll deprive patients of a great experience and your practice of a sales opportunity. Full disclosure and patient commitment will help you both over the long haul.