Contact lens hygiene compliance in a universitypopulation

doi:10.1016/0141-7037(93)80016-7

Journal of The British Contact Lens Association

Volume 16, Issue 3, 1993, Pages 105-111

Journal of The Briti...

https://doi.org/10.1016/0141-7037(93)80016-7 Get rights and content

Abstract

Hygiene practices of 207 contact lens wearers in a university population were surveyed using a self-administeredquestionnaire. Participants were then interviewed to clarify their responses; 178 subjects were asymptomatic. Individual hygiene standards were quantified with a weighted scoring system. Three months later, 48 of the least compliant subjects were reassessed. Of the 178 asymptomatic subjects, 23 (13%) were compliant, while a further 57 (32%) maintained reasonable standards. Inattention to lens case cleaning was the most common failing (128/178, 72%). Compliance was strongly associated with the length of contact lens experience (p<0.01). Reasonable compliance was found in 151 (85%) wearers after re-instruction, high-lighting the importance of regular revision of contact lens hygiene procedures.

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Cited by (46)

Compliance
2023, Contact Lens Practice, Fourth Edition
Noncompliance with recommended procedures can result in problems such as discomfort, drop-out, reduced vision and ocular pathology. The extent and pattern of noncompliance among contact lens wearers and the reasons for noncompliance are explored. A useful approach is to consider compliance with the incorrect and correct prescription. Strategies for compliance enhancement include improving initial patient education, periodic self-review and reducing the cost of lenses and lens care products. It is possible to predict which patients will be noncompliant based on known demographics and risk factors derived from studies of noncompliance in contact lens practice. A compliance enhancement model is proposed, comprising the clinic and practitioner, the patient, the advice and the contact lens industry.
The impact of patient behaviour and care system compliance on reusable soft contact lens complications
2021, Contact Lens and Anterior Eye
Reusable soft daily wear contact lenses (CLs) remain popular and were fit to just over half of all wearers in the most recent international CL prescribing survey. Unlike daily disposable CLs, reusables require cleaning and disinfecting after every use, along with storage in a CL case. These additional requirements add a number of steps to the daily wear and care routine, increasing the opportunities for CL wearers to exhibit non-compliant behaviour. The impact of non-compliance ranges from poor lens comfort through to potentially sight-threatening infective keratitis. The coronavirus pandemic has refocused the profession on the importance of hand hygiene in particular, and the need for promoting safe CL wear in general. This review summarises typical non-compliant behaviour related to reusable CLs, and examines strategies and opportunities to better support wearers. Patient education has a central role in encouraging compliant behaviour, although patient recall of information is low, and personal belief systems may result in continuation of non-compliant behaviour despite awareness of the risks. CL care solutions are required for the daily disinfection of lenses, however misuse of multipurpose solutions (MPS) and hydrogen peroxide (H₂O₂)-based care systems can challenge their ability to be fully efficacious. Standard efficacy testing is reviewed, with consideration of how well current protocols model real-world use of CL solutions. Although some recommendations are in place for the inclusion of additional variables such as lens cases, CL materials, organic soil and efficacy against Acanthamoeba, opportunity still exists to reevaluate global standards to ensure consistency of testing in all markets. Finally, potential future innovations are discussed which may further support increased safety in reusable lens wear through novel antimicrobial additions to both CL materials and cases.
Bacterial biofilm in silver-impregnated contact lens cases
2020, Contact Lens and Anterior Eye
Citation Excerpt :
However, the results of this study need to be validated in clinical trials prior to advocating the use of non-complementary lens care products. Patient factors such as compliance with hygiene procedures [7,30–32], age and gender [33] hand washing prior to handling the lenses [30,34] can influence lens case contamination. While patient compliance cannot be controlled as even written instructions have been shown to be insufficient [35,36], if care guideliness are simple consistent and effective, there is a better chance of compliance [27] which will add to the effectiveness of antimicrobial lens cases and multipurpose solutions.
This study investigated the efficacy of pre-conditioning lens cases on bacterial biofilm formation and removal.
Silver impregnated (MicroBlock / ProGuard™ & i-Clean) and control storage cases were pre-conditioned for 24 h with their respective multipurpose solutions (MPDSs). Cases were then inoculated with 2 ml of 10⁶ CFU/mL of ocular isolates of either P. aeruginosa or S. aureus and incubated for 48 h. Cases were subsequently disinfected (4−6 hours) as per the manufacturer’s recommended disinfecting time (MRDT) followed by the recommended case hygiene procedures - recapping wet (MicroBlock / ProGuard™ cases only) or rinse and air-dry or rinse, tissue-wipe and air dry (mechanical disruption). Surviving bacteria were enumerated using standard techniques.
Pre-conditioning the MicroBlock / ProGuard™ cases with MPDS significantly reduced biofilm formation (-1.1 log₁₀ CFU, p < 0.01 for P. aeruginosa & -1.3 log₁₀, p < 0.001, CFU for S. aureus) compared to the i-Clean lens cases. Maintaining the MicroBlock / ProGuard™ lens cases wet after the MRDT resulted in partial removal of bacterial biofilms (-2.9 log₁₀ CFU, p < 0.001 for P. aeruginosa and -2.6 log₁₀ CFU, p < 0.001 for S. aureus). Air-drying of all three types of lens storage cases after MRDT significantly reduced the bacterial biofilm (-5.4 log₁₀ CFU, p < 0.001 for P. aeruginosa and -3.5 log₁₀ CFU, p < 0.001 for S. aureus). Mechanical disruption produced the greatest reduction in the levels of bacterial biofilm in all 3 types of lens cases tested (-6.8 log₁₀ CFU, p < 0.001 for P. aeruginosa and -4.5 log₁₀ CFU, p < 0.001 for S. aureus). Synergi MPDS was significantly better than AQuify MPDS in removing bacterial biofilm from all 3 lens case types for case hygiene treatments with an air-drying step.
Pre-conditioning of silver-impregnated ProGuard™ lens cases inhibited initial bacterial biofilm formation. Synergi MPDS was more effective than AQuify MPDS in removing bacterial biofilm in silver impregnated cases and tissue-wiping significantly improved biofilm removal.
Hand hygiene is linked to microbial keratitis and corneal inflammatory events
2019, Contact Lens and Anterior Eye
Lack of or inadequate hand washing is a risk factor in the development of contact lens related microbial keratitis and corneal inflammatory events. In the public health domain there is compelling evidence that proper hand washing with soap can save lives. The purpose of this review is to draw attention to some of the public health literature in support of hand washing and how education can influence patients’ hand hygiene behavior. Contact lens wearers are also guilty of poor hand washing behavior but there is scant evidence that education of hand washing procedures of lens wearers alters patient non-compliance. It is well known that pathogenic microbial contamination of contact lenses, lens cases, care solutions and anterior ocular components have been found with contact lens wear. However while the originating source may be hands or water, it is most likely both of these. Besides proper hand washing this paper will include mitigating strategies for avoiding microbial contamination.
Compliance
2018, Contact Lens Practice
Health beliefs affect the correct replacement of daily disposable contact lenses: Predicting compliance with the Health Belief Model and the Theory of Planned Behaviour
2017, Contact Lens and Anterior Eye
To assess the compliance of Daily Disposable Contact Lenses (DDCLs) wearers with replacing lenses at a manufacturer-recommended replacement frequency. To evaluate the ability of two different Health Behavioural Theories (HBT), The Health Belief Model (HBM) and The Theory of Planned Behaviour (TPB), in predicting compliance.
A multi-centre survey was conducted using a questionnaire completed anonymously by contact lens wearers during the purchase of DDCLs.
Three hundred and fifty-four questionnaires were returned. The survey comprised 58.5% females and 41.5% males (mean age 34 ± 12 years). Twenty-three percent of respondents were non-compliant with manufacturer-recommended replacement frequency (re-using DDCLs at least once). The main reason for re-using DDCLs was “to save money” (35%). Predictions of compliance behaviour (past behaviour or future intentions) on the basis of the two HBT was investigated through logistic regression analysis: both TPB factors (subjective norms and perceived behavioural control) were significant (p < 0.01); HBM was less predictive with only the severity (past behaviour and future intentions) and perceived benefit (only for past behaviour) as significant factors (p < 0.05).
Non-compliance with DDCLs replacement is widespread, affecting 1 out of 4 Italian wearers. Results from the TPB model show that the involvement of persons socially close to the wearers (subjective norms) and the improvement of the procedure of behavioural control of daily replacement (behavioural control) are of paramount importance in improving compliance. With reference to the HBM, it is important to warn DDCLs wearers of the severity of a contact-lens-related eye infection, and to underline the possibility of its prevention.

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Journal of The British Contact Lens Association

Abstract

References (22)

Severe corneal infections associated with contact lens wear

Ophthalmol.

Corneal ulcers associated with daily wear and extended wear contact lenses

Am. J. Ophthalmol.

Contact lenses and other risk factors in microbial keratifis

Lancet

Negotiating compliance with contact lens care

ICLC

Microbial contamination of contact lens care systems

Am. J. Ophthalmol.

Comparative case contamination: three disinfection systems

ICLC

Microbial contamination of contact lens storage cases and solutions

Am. J. Ophthalmol.

Pseudomonas corneal ulcers associated with daily wear of disposable hydrogel contact lenses

ICLC

Patient compliance and its influence on contact lens wearing problems

Optom. Physiol. Optics

Review of clinical experience with microbial keratitis associated with contact lenses

CLAO J.

Patterns of lens care practices and lens product contamination in contact lens associated microbial keratitis

CLAO J.

Cited by (46)

Compliance

The impact of patient behaviour and care system compliance on reusable soft contact lens complications

Bacterial biofilm in silver-impregnated contact lens cases

Hand hygiene is linked to microbial keratitis and corneal inflammatory events

Compliance

Health beliefs affect the correct replacement of daily disposable contact lenses: Predicting compliance with the Health Belief Model and the Theory of Planned Behaviour