One of our biggest, but sometimes overlooked, goals as eye care providers is to improve success with our current contact lens wearers.

This includes presenting every patient—even those who seem content—with new and exciting lens options, such as daily disposable lenses. It is important to actively discuss the new materials and new modalities available, along with their improved health benefits.

Daily disposable lenses are the fastest growing modality in the contact lens industry, and they provide many well-known advantages over other modalities. While getting new patients into daily disposables is an exciting prospect, focusing our efforts on keeping current daily disposable wearers happy cannot be overlooked. If your office is anything like ours, the growth of the daily disposable market happens one patient at a time.

The Fallout Scenario
A “daily disposable refit” of a patient from an older lens type starts by first discussing the advantages and conveniences of the modality. The patient should then be provided with diagnostic lens pack, and brought back for a follow-up appointment five to seven days later.

A successful conversion ends by recommending that the patient purchase an annual supply of lenses, to take advantage of any company rebates as well as for its convenience.

For some patients, their next comprehensive eye exam may prove to be another hurdle. After the “honeymoon phase” has passed and patients have adapted to daily disposable lens wear, doubts may arise about whether or not it’s genuinely the right modality for them.

A year is a long time, and it gives the patient the opportunity to think about the cost of daily disposables. During this period, patients may also discuss their wear cycle with friends, and may begin to question the suitability of daily disposables for their needs and priorities.
  Fig. 1. Corneal ulcer possibly due to lens overwear and poor hygiene.

In an effort to save money (and, in some patients’ minds, be more environmentally friendly), they may consider going back to reusable contact lenses. This is a key moment in the patient’s contact lens lifecycle. Have a set plan for these moments, and be ready to answer any questions they may throw your way.

Consider these three steps to ensure continued daily disposable growth within your practice and prevent a ‘leak in the bucket’ of the adoption of this modality.

1. Educate and Re-Educate
As with most of what we do clinically, education lies at the heart of everything. Sometimes, patients need to be re-educated about the benefits and conveniences of daily disposable lenses. Be sure to remind them of the fees associated with each modality, including lens care products, and point out just how small the differences really are. This may be enough to keep some wavering patients in their daily disposable lenses.

Naturally, patients don’t know everything that we do. They don’t understand the scientific differences between the various modalities. They don’t understand the differences in surface chemistry between each type of lens. They may not understand risk factors, and how poor hygiene or contact lens overwear can elevate their risk of complications.

Take the time to remind patients of the reasons they were refit in the first place—in fact, consider reviewing aloud their symptoms and general ocular health status prior to their adoption of daily disposable lens wear. Be sure to emphasize how much healthier their eyes now look after wearing daily disposable lenses.

Explaining the process of ocular allergic reaction is a good way to demonstrate the benefits of daily lenses. For example, if you have a picture of allergic red eyes, show your patients how poor compliance while wearing reusable contact lenses can exacerbate the experience.

Explain that patients who use daily disposable contacts typically have fewer issues with lens deposits and cleaning compliance because a fresh, new lens is placed on the eye each day. In fact, one study showed that patients with ocular allergies experienced a significant increase in comfort when fit with daily disposable contact lenses.1

2. Give ’Em What They Want
If the patient asks to return to their previous wear modality, consider providing them diagnostic lenses of their old lenses and solution. Go over how to care for the lenses in detail, and remind the patient of the importance of rubbing and rinsing their contact lenses. Stress the possible ramifications if the patient doesn’t practice proper compliance.

The memory of the wear and care routine of their old lenses may be enough to prevent them from abandoning daily disposables. Call it the It’s a Wonderful Life scenario—these patients, like George Bailey in the holiday favorite, may rediscover their enthusiasm once the option is briefly taken away from them.

It is important to continually focus on the entire contact lens wearing experience, including lens care, material and modality. This entails getting a true account of the patient’s care routine and understanding whether or not they have strayed from prescribed wear and care patterns. If so, take the time to go over proper care techniques.

Fig. 2. Conjunctival chemosis and injection, as typically associated with seasonal allergic conjunctivitis.

Today’s contact lens wearers have many options to consider when choosing a modality that may improve the wearing experience, including single-use daily disposable contact lenses, two-week, one-month and the less common, quarterly/yearly replacement schedules.

Make sure they have all the information about their options, but make sure they understand that they will be sacrificing the convenience of wearing daily disposable lenses; thus may override the motivation to return to reusable lenses.

3. Refit, Yes. Revert, No.
If the patient reports increased comfort with their previous lenses, but prefers single-use lenses, consider upgrading to a newer daily disposable lens option.

In just the past 12 months, several new daily lenses have entered the market, including Dailies Total1 (Alcon), MyDay (CooperVision) and Miru 1day (Menicon).2 As contact lens specialists, we must be keenly aware of the distinctions among options, even within the same product category.

Comfort is king. Many studies have shown that more than one out of every two dropouts is due to discomfort with their current contact lenses. Knowing this, it is important to realize that our recommendations can have a significant impact on both the success and comfort of our patients.

Providing our patients with the most comfort possible needs to be an integral part of how we keep them happy in their contact lenses—even in those already wearing single-use lenses.

Case in Point
Kelly, a 25-year-old myopic contact lens patient, recently returned for her annual eye health examination and contact lens evaluation. She presented with mild end-of-day dryness symptoms, accompanied with slight distance blur.

Overall, she really liked the convenience of daily contact lenses and she was compliant with her wear cycle. She did not recall experiencing dryness symptoms with her previous reusable lenses. She asked about going back to her original lenses during this visit, as she felt they were more comfortable than her daily lenses.

After reviewing her previous exam findings, I reminded her of the allergic conjunctivitis incidents she experienced while wearing her monthly disposable lenses. As a result, I recommended refitting with a newer daily disposable lens design.

After discussing the latest options, I recommended upgrading to the new Dailies Total1 lens. She agreed and was ecstatic with the increased comfort level achieved by the lens’s water gradient design.

In summary, Kelly believed she would have no other lens options and would be forced to “settle” for her previous lenses. By upgrading her daily disposable lenses, we were able to improve Kelly’s experience with the modality and prevent daily disposable fallout.

1. Stiegemeier M, Thomas S. Seasonal allergy relief with daily disposable lenses. Contact Lens Spectrum. 2001 Apr;16(4):24-8.
2. Kading, D. One-day market, three new contact lenses. Contact Lens Spectrum, 2014 Jan;29(1):17.