Contact Lens Adaption in Neophytes

Abstract

SIGNIFICANCE Clinicians commonly either recommend patients begin contact lens (CL) wear full time or suggest that patients should gradually increase their wear times during the first few days of wear. This study found no differences between these two wear schedules, suggesting that patient preference may be the best schedule. PURPOSE The purpose of this study was to determine if there are any clinical differences in neophyte, 2-week, reusable soft CL wearers who were randomized to either a full-time or a gradually increasing wear time schedule. METHODS This was an investigator-masked, three-visit, randomized, clinical trial. Participants were randomized to wear their CLs full time starting on the first day or gradually starting with 2 hours of wear on the first day and increasing wear by 2 hours each day until 8 hours or more of wear per day was achieved. Symptoms (Ocular Surface Disease Index and visual analog scale) and ocular surface signs (tear breakup time, extent of corneal staining, and Schirmer test I) were evaluated at each visit. RESULTS A total of 25 participants were randomized, with 21 participants completing at least 1 week of follow-up. Completed participants had a mean ± standard deviation age of 23.5 ± 3.0 years, and 48% were female. No significant between-group differences were found when comparing the full-time and gradual wear time schedule groups at 2 weeks (all, P > .32): Ocular Surface Disease Index (10.8 ± 8.5 vs. 16.3 ± 18.8), visual analog scale (89.0 ± 9.7 vs. 81.8 ± 18.7), tear breakup time (11.7 ± 7.0 vs. 9.8 ± 2.7), extent of corneal staining (0.0 ± 0.1 vs. 0.3 ± 0.5), or Schirmer test I (15.9 ± 8.8 vs. 21.2 ± 12.5). CONCLUSIONS No between-group differences were found for any metric evaluated, which suggests that the best wear schedule may be the one that best suits the neophyte CL wearer's lifestyle.

2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management

“…218 Scleral lenses can stabilize a protective fluid layer on the ocular surface, 219 and we have revealed that they have little impact on corneal physiology in daily wear if the lens oxygen permeability is at least 125. [220][221][222] I have played a mentoring role to support academics in the British and Irish University and College Committee of Contact Lens Educators (BUCCLE) to review the evidence base for key areas of clinical contact lens practice 124,223 and conducted studies to address gaps such as the lack of adaptation time required after fitting neophytes 224,225 (which has now been replicated by another group) 226 and optimizing the grading of ocular physiology. 130 To consolidate the increasing evidence base in contact lenses, I brought together experts in the field to create the Contact Lens Evidencebased Academic Reports, published in 2023; this was an initiative to support clinicians in performing evidence-based practice to the benefit of their patients, to identify gaps in the literature for researchers to tackle, and to identify opportunities for industry to innovate.…”