Abstract
Purpose :
Discomfort is one of the key drivers for contact lens discontinuation. To understand the time course of discomfort in monthly lens wearers, this study was conducted to track and detail the symptom(s) that drive the replacement of contact lenses (CL) earlier than the manufacturer’s recommended replacement period (MRRP).
Methods :
This was a non-interventional, bilateral, prospective study on 17 (14 female, 3 male) monthly soft CL wearers (age 38 ± 8.8 years) who typically report the need to replace their CLs more frequently than the MRRP. Participants were instructed to wear a new pair of their habitual CLs, and subjective ratings of comfort, dryness, irritation and vision were tracked electronically on day 1, 3 and then every 3 days until they felt it was time to replace their lenses (final day). Ratings were recorded on a 0-100 scale at lens insertion, four hours of lens wear and just prior to lens removal (EOD). Lens replacement symptom(s) and ocular health were assessed at baseline and final study visits.
Results :
The average duration of lens wear was 21.9±4.1 days. There was no significant difference in comfort and other subjective ratings from day 1 (EOD comfort: 12.47±17.74) to day 15 of lens wear (EOD comfort: 25.80±18.41) (all p >0.05). However, as the lens wear duration approached 1-3 days of the final day, a significant increase in discomfort was observed as early as 4 hours after insertion (16.29± 17.58; p=0.01) and at EOD (33.06±21.47; p=0.02). Concomitantly, an increase in dryness (30±23.94; p=0.04) and a decline in vision (16.24±13.61; p=0.03) were noted at EOD.
The symptom reported most often, signaling lens replacement, was ‘dryness’ (41%) followed by changes in vision, itchiness and grittiness (each accounting for 11%).
No clinically significant change in visual acuity, lens fit, lens surface appearance or slit lamp signs were found to occur during lens wear.
Conclusions :
Subjective ratings remained unchanged for long periods of lens wear, followed by sudden considerable loss of comfort, increase in dryness and decrease in subjective vision just prior to the day lenses would be replaced. It is highly clinically important to note that the wearers in this study would have remained significantly uncomfortable for ~8 days if lenses were replaced as MRRP. It is recommended that practitioners identify the need for early lens replacement to ensure long term success with CL wear.
This is a 2020 ARVO Annual Meeting abstract.