In a time where cost often takes a back seat to the many conveniences in one’s life, fast food, cell phones and CD players, to name a few, it seems simple to accept the convenience of a daily disposable lens. But many practitioners in the United States haven’t jumped on the daily disposables bandwagon. According to organ et al (“International Contact Lens Prescribing 2002,” January 2003), contact lens practitioners in the United States prescribed daily disposable lenses for 5 percent of new fits, while Norway and United Kingdom practitioners prescribed daily disposables for 32 percent and 28 percent, respectively.
The Edge of Convenience
The majority of contact lens patients in the clinic of Paul Sorg, OD, in Edgewood, KY, think that daily disposables are the most convenient form of contact lens wear. Daily disposables are his number one modality of choice for patients.
“The number one benefit of daily disposable lenses is convenience,” says Gary Gerber, OD, practice management consultant in Hawthorne, NJ. Patients using daily disposable lenses find that this type of contact lens best fits their busy lifestyle and saves time in their day. The time saved comes from not having to use disinfecting solutions.
Says Chicago OD Pam Lowe: “Often my younger patients prefer daily disposables because of the convenience of the daily routine,” she says.
When wearing daily disposables, not only do her patients not have to bother with solutions at home, but also it creates “less to pack while traveling because they’re not packing bottles of solution,” says Dr. Lowe.
Daily disposable lenses succeed in Dr. Sorg’s practice because he is able to fit different types of wearers. “My full time wearers like that they save time on maintenance, and my part time wearers can put their lenses in right away without worrying about remembering when they last disinfected their lenses,” he says. “I will often test a standard disposable lens in one eye and a daily disposable in the other. My patients are happier with the comfort and vision of the daily disposable lens.”
Comfort A Key Issue
Comfort seems to be the second main benefit of daily disposable lenses. “These lenses are comfortable because they are cleaner and allow less time for deposits to build up,” says Dr. Gerber. “Therefore the patients will see better with the daily lenses. They’re comfortable because patients have fewer dry eyes and few allergy problems, and because there is less solution irritation.”
Clinical Reasons to Choose Daily Disposable Lenses
Contact lens practitioners applaud the obvious safety benefits of these lenses. “I offer daily disposable lenses to all of my patients, especially those who swim and dive,” says Louise Sclafani, OD, at the University of Chicago.
“Cleaner, safer and healthier” are the words Dr. Gerber uses when explaining to patients his choice of daily disposables.
Although daily disposables offer convenience and comfort to patients, some practitioners choose them for other clinical reasons in certain situations. Practitioners can use a daily disposable lens as a bandage for patients with a corneal abrasion or as a substitute for glasses while a patient’s glasses are being repaired and he does not have a spare pair, says Dr. Sclafani.
Other tips: use daily disposables instead of patient’s regular lenses after pupil dilation to prevent his current lenses from absorbing anesthetic and fluorescein. After pupil dilation for habitual lens wearers, slightly over-plus the patients so they can function for the rest of the day (maintaining 20/40 OU driving vision) or give +2.OOD OU over correction so that they can return to their office work.
Daily disposable lenses can aid in the training of staff and students on application and removal of lenses. Says Dr. Sclafani: “Both contact lens wearers and non-contact lens wearers can gain experience with the physical adaptation of lenses by using daily disposable lenses as trial lenses.”
Dr. Lowe finds daily disposable lenses successful and beneficial for patients with non-descript dry eyes that are often caused by multi-purpose solutions. Offer daily disposables to your gas permeable lens wearers for temporary use when participating in activities such as hiking, camping, climbing and swimming. Using these lenses may reduce the risk of debris lodging underneath the lens.
Although many contact lens practitioners understand the benefits of daily disposable contact lenses and know that patients desire more convenient lens wear, some practitioners make the mistake of judging a patient’s pocketbook rather than allowing the patient to decide for himself what he can afford. Alternatively, some patients undergo “sticker shock” when they hear the yearly cost for wearing daily disposable lenses.
“Cost is the number one reason for those who will not wear daily disposable lenses,” says Dr. Sclafani. Both Drs. Gerber and Sorg compare the convenience and the cost of daily disposable lenses to cell phones, extended cable networks and CD players in cars. “They all pay extra for those conveniences,” says Dr. Gerber.
When Dr. Sorg’s patients express concern for the cost of daily disposable lenses, his first question for them is how much their cell phone costs for the month. They often wonder how he knows they, have cell phones, although the relation becomes clear. The initial increase in cost for the patient to have a cell phone is small compared to the conveniences many patients enjoy by using daily disposables.
Dr. Gerber compares the cost of daily disposable lenses to the cost of adding anti-reflective and scratch coatings to spectacles. “Practitioners are quick to suggest the increased cost of glasses, but not with contact lenses,” he says.
Some practitioners compare the estimated $1 per day to the money spent on solutions in a year, not to mention the amount that people are willing to spend on refractive surgery. Practitioners who have been successful with daily disposable lenses believe that other doctors do not want to change from traditional methods of prescribing two-week disposable lenses because they are “good enough.”
Dr. Lowe says she only recently changed her mind set about using daily disposable lenses in her practice. Says Dr. Sorg: “Some doctors are used to their old ways and are not willing to make changes. Others will often prejudge what the patient will want when it comes to lenses and costs.”
Dr. Gerber thinks that some practitioners don’t present the option of daily disposables well because they are stuck on the price issue. “They think that their patient will say no to any changes, so they figure why even bother,” he says.
According to Dr. Sorg, patients are often uneducated about the differences among available lenses. “It is the doctors’ responsibility to educate their patients about products the same way they would for their own families,” lie says.
Practitioners who have been successful fitting new patients and/or introducing daily disposables to existing contact lens wearers generally introduce and explain the lens to all patients. “I do offer them to all of my patients,” says Dr. Sclafani. “I have some who wear only daily disposable lenses and others who wear them in addition to their other lenses for different occasions such as athletic activities.” Dr. Sclafani asks her patients how often they wear their lenses. She strongly suggests daily disposable lenses to her patients who only wear them a few times a week.
Says Dr. Sorg: “I introduce them and other specialty lenses to my patients in hopes that they tell their families,” lie says. “I’ll tell a 20-year-old patient about one-day multifocal lenses so she will tell her parents and grandparents, and they get the information.” Dr. Sorg has been successful in prescribing one-day multifocal and toric lenses to several patients in his practice. “Doctors should be giving their patients the best information on the market,” he says. “Those in my area who don’t are only making me look better.”
Dr. Gerber reminds doctors that it is the patients’ decision as to what they want to choose and the doctors’ responsibility to give them all of the information for the best, healthiest eye care. He suggests leaving price decisions to the patient. CLS