I would argue that almost all contact lens complications result from poor compliance. All too often instructions are misunderstood or ignored. This is one of the key reasons why internet supply of contact lenses or pharmacist supply of care systems are problematic as there is limited opportunity for eye care practitioners to ensure patients understand what they should be doing and can adapt this as appropriate over time. This, of course, does assume that the eye care practitioner is able to give the correct information.
Against this background, all of the judges were very keen to learn the outcome of a questionnaire-based study shortlisted as one of the CooperVision Student of the Year finalists. The aim was to see how well undergraduate optometrists and pharmacists adhered to the appropriate behaviours for full time wear of soft contact lenses.
Finalist – Ali Jiwa
Project – Soft contact lens compliance amongst undergraduate students
Supervisor – Dr Amit Jinabhai
Ali Jiwa designed the questionnaire and distributed it via email and social media. In order to do so, the project had first to be approved as compliant with University ethics policy. Cleverly, among the expected questions, Jiwa had included some ‘trigger’ questions (figure 1). For example, if a respondent says they are ‘not sure’ how often they need to change their lenses, then there is clearly a concern regarding compliance.
Figure 1: Questionnaire
Results
Overall, there were 80 respondents of which 63 were sufficiently robust (figure 2). The judges, all of whom had some experience with questionnaire design and distribution, were impressed by its construction and also the level of response achieved.
Figure 2: Respondents
Figure 3 shows the modality of wear for respondents. The tendency for optometrists is for daily wear, pharmacists monthly wear. This was probably just as well, as one of the pharmacy students in dailies admitted to storing and re-using them.
Figure 3: Modality of wear
Other findings of interest included;
- Well over half of both groups admitted to having a nap in their contact lenses, with the optometrists doing so more than pharmacists.
- 10% or fewer in each group sleep in their lenses on a regular basis.
- More than 50% of both practitioner groups admitted to taking a bath or shower, or to washing their face while still wearing their contact lenses.
- 67% of pharmacy students who swim with their lenses in either do not always wear swimming goggles over their lenses or do not wear goggles at all.
- One optometry student does not wear goggles at all (‘compliance or complacency?’ wondered Jiwa).
- 11% of pharmacy students have rinsed their CLs in tap water.
Conclusion
The judges felt that this was a useful and fascinating study, only limited by the concerns often levelled at this sort of research, such as the use of a very non-representative population. Best of all, Jiwa analysed the figures in a way that elicited some useful learning outcomes that he argued should be borne in mind by all in contact lens practice.
These were:
1 Give written and verbal information to take away and keep.
2 Repeatedly explain, and physically demonstrate, what good compliance is. Remember, there is always a risk of compliance failure.
3 Practice what we preach.
Useful indeed.
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