I read the June 2011 issue of Review of Cornea & Contact Lenses with interest. I noted four separate articles that addressed contact lens compliance and wearing schedule issues: Dr. Craig Wood’s “Getting Patients to Comply with Lens Replacement” (advertorial); Dr. Mark Abelson and Dr. Jason Chin’s “Non-Compliance: A Continued Concern” (Naked Eye); Dr. Michael Mayers’ “Contaminating Contact Lens Care Compliance: The Sterilizing Truth” (advertorial); and Dr. Melissa Barnett and Dr. Chris Smiley’s “Which Soft Contact Lens Replacement Schedule Do You Recommend.” The plethora of articles in all the optometric literature dedicated to contact lens compliance issues reveals the widespread nature of these problems.

Every practitioner who fits contact lenses is currently dealing with compliance issues.

I have been very curious as to why no contact lens manufacturer has developed a weekly replacement soft contact lens. Vistakon and CIBA Vision seem to be “at war” trying to convince us that one replacement cycle keeps patients more compliant than the other. Doesn’t it make sense that a weekly replacement contact lens would be much easier to know when to replace than either a two-week or monthly lens?

“Mrs. Jones, I would like you to pick one day during the week and replace your lenses on this day every week.” It is certainly an easier schedule for me to remember and I think most patients would find it easier to comply to their doctor’s recommendations.
I think most practitioners would agree that daily disposal lenses have the highest rate of compliance. I also believe these lenses are healthier in the long term due to less filming, depositing and dryness issues.

A one-week replacement lens would offer better corneal health than two-week or monthly replacement lenses because the patient would have a “cleaner” lens on the eye more often. I feel a weekly replacement lens would rank second behind daily disposable lenses in terms of best patient compliance and ocular health. Also, since contact lens manufacturers can produce daily lenses at an affordable price, they certainly could make a weekly lens that patients could reasonably afford.

I believe that if Vistakon, CIBA Vision, Coopervision and Bausch + Lomb truly care about contact lens compliance issues, they will strive to produce better products and systems. One currently available method to improve patient compliance is to fit daily disposable contact lenses. Another solution they could offer contact fitters is to develop a weekly replacement contact lens.

Maybe the manufacturer’s advertising and research dollars being spent on proclaiming “our lens disposal time is better than yours” would be better spent giving fitters a weekly disposal contact lens. 

Patrick J. Wellik, O.D.
Apple Valley Eye Care
Saint Paul, Minn.