A voluntary code of practice for contact lens retailers has so far been the ‘one that got away’ for policy makers at the GOC.
Thwarted by a lack of evidence, other priorities and geographical barriers, it was decided to ‘park’ the illegal practice code, through which compliant contact lens vendors would have gained a stamp of approval.
Instead, the regulator has committed to improving public awareness of contact lens wear – through research, PR and most recently a campaign.
‘Love Your Lenses’ was launched in March to flag up the importance of safe contact lens wear, and rekindled the debate about illegal contact lens wear during its last quarterly council meeting.
The regulator presented the outcomes of its campaign, before Council members discussed the future role of the regulator, and wider sector, in clamping down on contact lens malpractice.
GOC communications manager Simon Grier said: ‘Behavioural change is not something that happens overnight.’
Love Your Lenses was described as a stake in the ground to improve awareness of contact lens compliance among wearers.
‘We’ve had very good stakeholder support,’ Grier said.
This included backing from optical bodies, multiple chains, independents and hospital eye care providers. The key messages they delivered were to wash hands before touching the eye and ‘don’t lose sight of your optician’.
A website was created and since updated to offer advice on summer contact lens wear. Cosmetic contact lens advice was set to follow in the lead up to Halloween, Grier told Council members. Supporters of the campaign used posters, infographics and social media resources to promote the awareness drive between March 25-31.
However, Council members were keen to set the right tone without putting patients off, and other optical bodies urged to play a greater role. There was also a sting in the tail when Optician asked a leading online contact lens retailer for his thoughts on the code.
Case study
Grier explained how the 2017 campaign culminated in patient Irenie Ekkeshis featuring on the BBC News homepage, telling her story of experiencing terrible pain caused by Acanthamoeba keratitis. Following two unsuccessful corneal transplants she became blind in one eye, but wanted to raise awareness of water exposure while wearing contact lenses.
Ekkeshis has won award for her ‘No Water’ campaigning, and was also earmarked by the GOC for turning a negative experience into a campaigning tool.
‘Our role was as the conductor rather than the orchestra,’ Grier said. ‘On one hand, we wanted to raise awareness but on the other we wanted to avoid scare stories.’
It also followed feedback from the public showing many were not aware of some of the most basic hygiene tips, such as avoiding water.
While public engagement in the campaign was rated highly, exposure was impacted by more significant news developments in March, such as the Westminster terrorist attack and the triggering of Article 50 to leave the EU, Grier added.
There was no accounting for such developments, and in the lead up to the GOC meeting national media was reporting the case of an eye patient attending cataract surgery unaware she had 27 contact lenses stuck in one of her eyes.
It was suggested the next campaign could fall during the quieter summer months and specifically target certain groups such as swimmers or students.
‘We want to get more targeted in the future,’ Grier told Council members. ‘It is something that is applicable to all contact lens wearers but also really easy for patients to get on board with and for practitioners to explain to their patients.’
Balancing out the fear factor
Council member and optometrist Dr Scott Mackie praised the execution of the campaign but stressed the need for balance. He said: ‘We’ve got to watch that we don’t put people off, and should also tell some positive stories.’
He suggested telling the public more about contact lens wear in sports such as athletics, and the benefits of Ortho-k for short-sighted child patients. ‘By being positive we can still pick up on the negatives.’
Council member Selina Ullah suggested offering the public more advice for emergencies, such as when they did not have access to their contact lenses, solutions or cases. She called on hotels and the multiples to think about helping patients stranded without prescribed products.
Council member and optometrist Helen Tilley, meanwhile, stressed the Love Your Lenses campaign should have full cross-sector involvement, including among independents.
She said: ‘Campaigns in the past have got the big companies on board and it has alienated the rest of the profession.’
As for the tone of campaigning, she too called for some positivity to be added to the message around contact lens wear and compliance.
Nevertheless, in an analysis of sentiment following the campaign, Grier said that a tiny minority concluded they were ‘not sure they wanted to wear contact lenses anymore’.
Contact lens wear was just one strand of the GOC’s illegal practice strategy, first proposed three years ago to cover all types of illegal practice prohibited by the Opticians Act. ‘I don’t want all the other areas to get lost,’ added Tilley.
Nonetheless, the supply of contact lenses has been a constant battleground for high street optics struggling to keep pace with the internet. This was where not ‘losing sight of your optician’ became especially crucial.
Council member Sinead Burns said: ‘I’ve used contact lenses for 20 years and while I was aware they shouldn’t come into contact with water I did not realise until the campaign it could result in someone losing their sight, so it is a very worthwhile campaign. So people often don’t realise the consequences of not following the advice.’
Council member and optometrist David Parkins added: ‘You have to keep saying the same things to patients over and over again. Have they listened? Have they taken it in?
‘People don’t always associate the dangers of misuse with losing their sight.’
He called for more involvement with eye hospitals such as Moorfields Hospital, which sees the vast majority of severe cases first hand, while also spreading the message that non-contact lens wearers can also get Acanthameoba.
‘Many are using disposable lenses but when you are using a case and it can get slimey,’ Parkins added. ‘Then it’s about keeping your case clean rather than water per se. It is the whole aspect of contact lens care that needs to be raised in people’s awareness.’
Despite the stakeholder involvement in Love Your Lenses, other optical bodies were called upon to help clamp down on non-compliant contact lens wear and sales in future.
GOC chair Gareth Hadley said: ‘I am concerned that the industry does not seem to have taken as much of a lead in this matter.
‘In the past, there has been a fixation that this is an issue for the GOC to sort out, and I would like the ACLM to move into a different place in their role as a trade association.’ He called on the College, BCLA and Optical Confederation members to play a central role too.
Meanwhile, GOC director of strategy Alistair Bridge told the Council meeting the GOC had improved links with trading standards and started to send out warning letters to unverified cosmetic contact lens sellers.
Having investigated illegal practices in optics with research among wearers, the GOC had decided to home in particularly on contact lens retail.
Meanwhile, Bridge described substitution as a ‘real sticking point’ for the sector. Hadley agreed, adding: ‘There is no evidence available to us on the harm of substitution. In the absence of evidence of harm we are not in a position to produce a code of practice on this. If anybody out there has the evidence, now is the time to produce it.’
In delaying the voluntary code two years ago, the GOC also omitted provisions relating to substitution of contact lenses – a decision hailed at the time by Daysoft founder Ron Hamilton.
Asked about the prospect of revisiting the code this week, Hamilton was equally defiant.
He told Optician: ‘The code’s actual intended consequence was to prevent/curtail substitution unless “blessed” on each occasion by an optician. It was nothing to do with trustworthy internet retailers. It was the work of a cartel headed by the GOC and encompassing its stakeholders.
‘The code was an overt attempt at a restrictive practice based on zero evidence, an appalling situation which ultimately caused the plan to go in the bin as the GOC had to publicly announce in May 2016 when faced by the lack of evidence of harm. The optical players need to realise the world is moving on and the current archaic business model is bust.’
Nevertheless, Love Your Lenses reached beyond the process of selling contact lenses and into the public mindset. Even without a code to impose, the GOC’s campaign has helped keep the contact lens debate alive.