Contact Lens Spectrum
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c l s p e c t r u m . c o m C O N T A C T L E N S S P E C T R U M S P E C I A L E D I T I O N 2 0 1 6 25 Dr. Epstein is a partner in Phoenix Eye Care in Arizona where he is director of clinical research and head of the Dry Eye – Ocular Sur- face Disease Center. He is a shareholder/owner of NovaBay. He is a consultant/advisor to Alcon, B+L, CooperVision, EyeEco, Nova- Bay, Oculus, PRN, SBH, Shire, and Johnson & Johnson Vision Care. Ms. Wilson is director of strategic insights, Bausch + Lomb. Dr. Reindel is executive director of medical affairs, Vision Care, Bausch + Lomb. connected to their contact lenses. In some cases, a pa- tient's need to please the doctor and the doctor's need to avoid negative focus can circumvent potentially benefi- cial discussions. Regardless, this research highlights the need to expand the dialogue with contact lens wearers. Breaking down complex science into simple stories can help communicate knowledge as well as caring. To a patient, learning that the eye's surface faces challenges similar to the surface of a contact lens may seem puz- zling or unimportant at first. However, understanding that keeping a dry surface wet is no easy task will help them appreciate the complexity of what clinicians do. It also underscores the incredible depth of technology that has been developed to help keep them successful contact lens wearers. Expanding the dialogue to target experiences of typi- cal wearers may reveal troublesome symptoms the pa- tient has never mentioned. For example, a few simple questions could reveal a wealth of information, such as: • Many contact lens wearers begin to experience blurry or fluctuating vision in the morning. Do you ever experience blurry or fluctuating vision during the morning, particularly if you have been working on your computer? How about in the afternoon? • Do you find you are blinking rapidly or rubbing your eyes to clear your vision? • When you are concentrating on your driving, do you find that you rub your eyes to clear your vision? • Do you use drops to relieve dryness in the after- noon or evening? • In the evening, do your eyes feel tired after a long day of wearing lenses? Do you find yourself wanting to remove your lenses before you would like to? Reassuring patients that these symptoms are not just the normal consequences of long hours at the computer — in other words, their fault — and that their contact lenses may be contributing to their symptoms of blurry or fluctuating vision, dryness, or tired eyes, provides an open- ing to a positive discussion about contact lens options. Participants who experienced blurry or fluctuating vision, dry eyes, or tired eyes expressed high interest in a product that could prevent or reduce these symptoms (Figure 7). Ideally, a well-designed contact lens will be physio- logically unobtrusive. Contact lens surfaces that cannot sustain wettability throughout the day can cause blur- ring and comfort issues for patients. For these reasons, it is important to fully understand how lenses are designed and materials formulated and, perhaps more important- ly, how they function within the ocular environment. If a key purpose of the tears is to create a smooth refracting surface, it is critically important that a contact lens in- terposed within the tear structure promotes and sustains clear, comfortable vision. Patients will appreciate an expanded dialogue and lenses that help them maintain comfortable vision throughout their day. REFERENCES 1. Craig JP, Willcox MDP, Argüeso P, et al. The TFOS International Workshop on Contact Lens Discomfort: Report of the Contact Lens Interactions With the Tear Film Subcommittee. Invest Ophthalmol Vis Sci. 2013;54:TFOS123-156. 2. Mann A, Tighe B. Contact lens interactions with the tear film. Exp Eye Res. 2013;117:88-98. 3. Kadence International. Exploring blurry, changing or fluctuating vision associated with contact lens wear. January 2012. 4. Ablamowicz A, Nichols JJ. 2016 Report on dry eye diseases. Contact Lens Spectrum. 2016;31(7):24-31. VISUAL PERFORMANCE UNEXPECTED WORDS THAT MAY SIGNAL BLURRY VISION P atients may not always be able to describe their blurry vision as such. The key words and phrases highlighted below were used by par- ticipants in this study to describe how blurry vision made them feel. Comments such as these may be red flags identifying patients in distress. Recogniz- ing them as such allows practitioners to reassure them and proactively address their issues. UFP.0263.USA.16