Contact Lens Spectrum Supplements

Special Edition 2017

Contact Lens Spectrum

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c l s p e c t r u m . c o m 15 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 7 CONT ACT LENS CARE & COMPLIANCE A N D R E W D. P U C K E R, O D, P H D Dr. Pucker is currently an assistant professor at the University of Alabama at Birmingham. He has also received research funding from Alcon. You can reach him at apucker@uab.edu. 1. Carry Care Products I always tell my specialty CL wearers to carry their care products with them throughout the day. This is especially important for scleral lens wearers who experience mid- day fogging. The mechanism of midday fogging is currently un- known, but it may result from tear film components or a poor fitting scleral lens. Midday fogging is typically treated by removing the lenses, cleaning them, and reapplyng them with fresh saline (Walker et al, 2016), a task that cannot be completed with- out having the proper tools on hand. Having care products handy could also be helpful for removing irritat- ing dust or debris that is trapped un- der or on a specialty CL. 2. Discard Old Care Products I always educate my patients that old care products could harbor potentially vision-threatening patho- gens (Panthi et al, 2009; Wu et al, 2010). One study provided convinc- ing evidence that using CL cases that were older than 6 months was a risk factor for developing microbial keratitis (Stapleton et al, 2012). tap water should be avoided while caring for CLs unless specifically indicated by the care system's man- ufacturer, because tap water may contain unwanted pathogenic mi- croorganisms (e.g., Acanthamoeba) (Vesaluoma et al, 1995; Choo et al, 2005). If the care regimen involves directly applying saline solution to the eyes (e.g., scleral lens wearers), I further educate patients that they should select nonpreserved saline over preserved saline because the preserved saline contains mole- cules that could lead to eye irrita- tion (Sweeney et al, 1999; Pucker et al, 2016). Don't Let Them Forget Convincing patients to maintain good care and compliance habits is a constant challenge, as CL compli- cations are relatively rare (Davidson et al, 1980). Nevertheless, I believe that it is our duty to continually remind our patients about the im- portance of good CL care habits, especially those that they frequently fail to correctly complete. CLS For references, please visit www. clspectrum.com/references and click on document #SE2017. Although there is no firm time- line for discarding cases, the pre- ponderance of the data suggests that wearers should do this at least every 3 months (Stapleton et al, 2012; Panthi et al, 2014). With that said, I generally tell my patients to replace their case every time they open a new care solution bottle. Similarly, there is evidence that CL application and removal de- vices can support microbial growth (Logan and Perrigin, 2017); there- fore, I recommend to my patients that they should regularly clean their devices and replace them at least every 3 months. 3. Saline Choice Matters I always educate my patients about the differences between tap water, preserved saline, and non- preserved saline. I highlight that TOP THREE TIPS FOR CARING FOR SPECIALTY CONTACT LENSES S pecialty contact lenses (CLs) are great for treating a variety of patients (Harthan et al, 2017). While recent material advances have made specialty CLs safer than ever (Harthan et al, 2017), wearing them, especially scleral lenses, brings about additional considerations. Caring for specialty CLs involves many of the same tasks as caring for soft CLs (e.g., good hand hygiene, following care system directions, reporting for regular eye exams, etc). However, there are three tips that are particularly important for specialty CL wearers that I like to discuss with my patients (Robertson and Cavanagh, 2011; Zimmerman and Marks, 2014). I t i s o u r d u t y t o c o n t i n u a l l y r e m i n d o u r p a t i e n t s a bo u t t h e i m po r t a n c e o f g o o d C L c a r e h a b i t s .

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