Working together to prevent contact lens dropout

Previous studies tell us that almost a quarter of patients fitted with contact lenses will choose to discontinue wear within the first year, with the cause of drop out stated as difficulty with handling, issues with dryness or discomfort, or vision not meeting expectations. Almost half of these new wearers who discontinue will do so in the first two months. As practitioners, these figures can help us to reflect on the importance of that initial contact lens wear experience, and how helping the patient to get the right level of support during this time can help them to become a long-term, happy and loyal contact lens wearer.

An approachable and well-trained team can make a big difference in helping patients feel comfortable with the application and removal process

The initial fit appointment

Starting out well is an important step in future success and satisfaction. In the initial contact lens consultation, I ensure I invest the time in having a detailed discussion about the patient’s visual and lifestyle needs. The more I understand the patient’s day-to-day activities – work, lifestyle, sports and hobbies – alongside their expectations from contact lens wear, the better placed to set realistic expectations in a positive manner and to suggest a personalised visual solution. This is particularly important for patients with challenging refractive or ocular demands to avoid disappointment later in the journey.

When it comes to selecting the most suitable lens for each patient, I always ensure I take into account the patient’s tear film along with their refractive needs. This allows me to select the best material and optical design for the patient. This, together with ensuring I follow the manufacturer’s fitting guide – which is particularly important for multifocal lenses – will ensure I get the best chance for a successful fit without wasting chair time.

Even when I feel I have selected the best contact lens option for the patient, I ensure I have a ‘plan B’ available and will let the patient know that the first lens they try may not be the final lens I prescribe. Keeping the patient informed that there may be some tweaks or alternative options available can be reassuring if issues arise in the initial trial period.

Having a ‘contact lens buddy’ in the practice who follows up with new wearers during their trial period so that problems can be dealt with quickly before the patient gives up is key

Handling

A successful teach is such an important part of the patient’s journey into contact lenses. An approachable and well-trained team can make a big difference in helping patients feel comfortable with the application and removal process. I ensure each team member is well trained to not only provide practical information, but to also provide encouragement and remind patients about their initial motivations for contact lens wear. This can make a big difference if you have a patient who is struggling in the initial stages of contact lens wear.

For all patients, we also provide written information, or links to handling videos, to help ensure that, if the patient does forget something, they are able to access the information later.

Providing support and reassurance to the patient to ensure they feel able to ask further questions or for further guidance will help to build a strong relationship between them and your practice. The practice team is often the first contact point with our patients and so it is important that the team feels empowered and have the correct knowledge to deliver information to the patient and know when they should refer questions to the clinician. Having a ‘contact lens buddy’ in the practice who follows up with new wearers during their trial period so that problems can be dealt with quickly before the patient gives up is key.

A successful contact lens practice really does rely on the whole practice team to ensure the patient feels supported on their journey into contact lens wear

Initial review

The initial review appointment is my opportunity to gauge success, and to understand how well the patient’s experience with contact lenses has gone. A patient feeling disheartened about the length of time it still takes to apply and remove their contact lenses may need reassurance that these are still early days, and that all new skills take time to master. Equally, for a patient whose experience hasn’t been as they anticipated, active listening followed by knowledgeable and empathic responses can often relieve any anxiety.

After the end of the initial trial aftercare, we set a reminder for one of the front of house team to call the patient in a month to see how they are getting on – this ensures that any small issues such as visual or comfort concerns can be dealt with at an earlier stage before developing into a bigger issue. We find bringing the patient back for a three-month aftercare is also really beneficial as another opportunity to address minor teething issues. By encouraging patients to join the practice contact lens plan, all appointment costs will be covered – this can avoid patient hesitation in booking further appointments if a problem occurs.

A successful contact lens practice really does rely on the whole practice team to ensure the patient feels supported on their journey into contact lens wear.

Top tips

1. Even when you feel you have selected the best contact lens option, have a ‘plan B’ available in case
2. Ensure all team members are trained to provide practical information, as well as encouragement, reminding patients of their initial motivations for contact lens wear
3. Ensure the front of house team calls the patient one month after the review to see how they are getting on.