The International Association of Contact Lens Educators

1. The International Association of Contact Lens Educators

3. 'Importance of lens care and follow-upRajeswariMahadevan Team effort between practitioner and the patient

4. What’s discussed? • Importance of compliance, patient education • Follow up - Why and what to look for? • Enhancing patient education tools • Various ways to ensure compliance

5. First peer reviewed contact lens Compliance related publication 1986… • At least one aspect of non-compliant behaviour was seen in 74% of patients.

6. Definition of compliant lens wearer! • Chun and Weissman 1987 • “One who correctly handles, cleans and wears his contact lenses” 1987 2016 (Buietal 2011, Robertsonandcanagh, 2011, Ramamoorthy and Bichols 2014) • 90% wearers do not comply with all steps • Sounds simple but long list of dos and don’t’s

7. What do Health care providers say? • 1/3rd • Follow instructions exactly • Follow some instructions • Will not follow instructions at all….

8. Serious areas of noncompliance Serious areas ofnon-compliance Exposing CL or lens case to tap water Failing to wash hands Failing to rub and clean Failing to rinse lens Overnight wear Use of cosmetic contact lens without prescription Topping of solution

9. 1996

10. 1997 40-90% of patients are non-complaint and difficult to predict in individual patients.

11. Compliance enhancement model-1997 • The clinic and the practitioner • The patient • The advice given • Contact lens industry

12. 2016

14. Lens case contamination • 50% of lens cases showed microbial growth

15. 2016 EIVOC 2015

16. 2017

17. Remedy: Change in lens care and replacement modality • Daily disposables • Studies reported increased market share of DD and hence better compliance and replacement schedule….

18. Daily disposable study

19. Challenges with daily disposable? • 15-18% fail to replace contact lenses as recommended (Dumbleton 2010) • Wearing and sleeping with lenses • Reusing the lens same day or later. • Does not wash hands • DD may not be an option in all refractive errors and ocular conditions • Still carry some risk of MK (2in 10,000)Sankaridurg 2013

20. Improper knowledge Better solutions & simple steps No rub Urgent use Hand hygiene Steps to be followed

21. Lens case Air drying Hand hygiene Lens Replacement Tap water use Place of storage

22. Serious areas of noncompliance Serious areas ofnoncompliance Exposing CL or lens case to tap water Failing to wash hands Failing to rub and clean Overnight wear Failing to rinse lens Use of cosmetic contact lens without prescription Toping of solution

23. Possible reasons for noncompliance Treatment duration Forgetfulness Missing follow-up schedule Trying to save money Lack of time Perceived lack of harm Trying to save money

24. Various ways to ensure compliance

25. Reasons for non compliance • Too many information in one session • Reduced capacity to learn due to anxiety • Large demand for learning capabilities • Specific learning difficulties • Conflicting information • Risk taking capacity • Start a discussion without offending • Example redness compliant – • Patients expects problem with lens • you see papillae and roughness • Instead of saying something about infection better to talk about around 20% of the patients failures because of lens cleaning procedures • Self assessment questionnaire

26. Use motivating displays and positive feedback Using the principles of social influence to improve education and attitudes toward compliance

27. Follow-up care ….

28. How frequently should you examine contact lens patients? • No simple answer • Depends on…. • History • Type of condition • Lens type • Modality • Ocular health • Replacement schedule • Life style

29. Follow-up and followthrough…..

30. 2014

32. 2011 • 14 countries • 4021 particpants survey

35. Enhancing patient education tools

36. Action points 10 Steps to Improving Contact Lens Compliance Educate Your Staff and Your Patients • Put Instructional Videos to Use • Make Time for Personal Instruction • Show Them You Care • Review Lens Care at Every Visit • Get Their Attention • Let Them Read All About It • Offer Solutions in Your Office • Keep Patients Coming Back for More • Get Your Patients to Commit

37. Practitioners recommendation for lens care

38. How much solution to use?

39. How to followup compliance effectively?

40. 2011- Easy way to recall contact lens products

42. Lens care posters and Pamphlets – different resources

43. Attractive ways to present do and don’ts

44. Lens replacement reminders and followup with mobile application

45. Reminder calls, texts and emails….

46. Take home message…. 10 Steps to Improving Contact Lens Compliance Educate Your Staff and Your Patients • Put Instructional Videos to Use • Make Time for Personal Instruction • Show Them You Care • Review Lens Care at Every Visit • Get Their Attention • Let Them Read All About It • Offer Solutions in Your Office • Keep Patients Coming Back for More • Get Your Patients to Commit

47. IACLE would like to thank our Industry Partners for their ongoing support of the development and delivery of educational resources and programs Platinum Sponsor Silver Sponsors Bronze Sponsor Donor Sponsor

48. Please visit us online at www.iacle.org