It was about a year ago that we first heard reports of Fusarium keratitis outbreaks in
Meanwhile, full-page newspaper announcements offered advice and information about the developing situation. Bausch & Lomb went so far as to prominently feature its executives in commercial spots, reassuring the public that the company would do the right thing and protect public health at all costs. Unless you lived under a rock, you couldnt avoid the news.
The contact lens-wearing public was scared. As you know, even if a patient is aware of the potentially devastating effects of failure to comply with an appropriate lens care regimen, he will likely try to push it out of his mind when hes tired and doesnt feel like rubbing his lenses, or when the bottles almost empty and he puts his dirty lenses in yesterdays solution. But, its not so easy to ignore the voice in the back of your head (yes, most patients have one of these) when, every time you flip the channel, youre bombarded with ominous-sounding newscasts warning you of the hidden danger of contact lenses.
Patients werent the only ones scared by what they saw on the news. Optometrists were worried, too. You were quick to get on board with efforts to eliminate Fusarium cases. While its an interesting clinical finding, no optometrist wanted to find it sitting in his own exam chair. O.D.s worried not only about appropriate and timely diagnosis and treatment; they also were concerned about lawsuits. What if a patient went blind and claimed that it was your fault because you never went over proper lens care with her?
Despite the negative press and the fear it instilled, most patients didnt stop wearing their lenses. Thanks to the efforts of optometrists and lens care manufacturers, who highlighted the role that non-compliance can play in ocular infection, the overwhelming press actually may have created a positive outcome to an otherwise grim situation.
In this years 30th Annual Contact Lens Report, Review reports on how the Fusarium outbreak changed the way O.D.s educate their patients (see What Have We Learned from the Fusarium Outbreak?). Author Edward S. Bennett, O.D., reports that as many as 32% to 80% of patients do not totally comply with their doctors instructions. Indeed, factors implicated in the outbreak of Fusarium keratitis included the omission of important steps in the lens care process, such as not using fresh solution every day, not rubbing the lenses after removal, and not adhering to recommended replacement schedules.
These very well may have been contributing factors in many of the 164 Fusarium cases confirmed by the Centers for Disease Control and Prevention. For that reason, Dr. Bennett reports that half of all respondents to his survey of the Advisory Committee of the GP Lens Institute (GPLI) say that they have changed how they educate their patients.
Dr. Bennetts article provides seven steps to healthier lens care, a compliance checklist and a lens care compliance agreement.
With proper education, you can infect patients with the truth about lens carewhich is much more pleasant than the alternative.