Contact Lens Abuse and How to Handle It

We all have them: the 15-35 year old patient who literally wears the same pair of disposable contacts w/o removing them for months at a time. Some of them even BRAG about it! "Yeah I've had THIS pair in for 6 months! Hahaha!!!!", like it's cool and funny. Or they announce that they "know when" to change contacts because they "start hurting" and all that. Obviously they're putting their health at risk. Some of them have symptoms: red eyes, dryness, etc, but a lot of them are totally fine. No redness. No pain. Corneas are clear. It's all fine! So what's the problem? An optometrist really has to be careful here. People do not like to be reprimanded, even when they know they're wrong. If you "cut them off", not allowing them to have any trials or buy any boxes, they're just going elsewhere, and probably give you a negative review on Angie's List/Google to boot. Then you've both lost their business and sent your problem patient to some other unsuspecting eye doc. And those patients are much more likely to lie to the next doc because telling the truth about their contact lens habits got them cut off from buying them, so now their vision is even more at risk! No, we must tread lightly. I find that people generally despise being scolded or having scare tactics used on them. It's a turn off. I really believe the best way to handle it is to NICELY and maybe even laughingly say something like "well you know we recommend that for your safety and long term vision you need to be taking the contacts out nightly and changing them regularly...the brand you're wearing is designed for two weeks of daily wear". We're just kind of politely reminding them to do the right thing. I usually jokingly throw in something like "you know - people who smoke 2 packs of cigarettes a day usually feel great! They don't think it's a problem at all until one day someone diagnoses them with lung cancer!" Have any of you patients experienced some optometrist "yelling" at you about the way you wore your contacts? Any of you docs have a method of patient education that you wish to share? Chime in below in the comments section!


  1. Move 'em to dailies if possible - compliance is so much better. Explain the benefits of daily replacement, that you get a fresh pair of lenses every day, and that it fits better with the particular patient's lifestyle. This will woo a number of people.

    For the others, it's a careful balance because these patients tend to be cost conscious... the breathable SiHy daily disposables such as DT1 and TruEye are not cheap... and they tend to be sturdier than daily hydrogels, which might make compliance an issue. In those cases, maybe fit them in a cheaper daily while they are younger, and then move them to a more breathable/comfortable lens once they appreciate the difference and can better afford it?

    In any case, I do agree - don't yell at them, shame them, etc. That has a 0% chance of working.

  2. yes! dailies are a great idea! and you're completely correct - much more likely to be compliant! thanks for the comment!

  3. Show them pictures of what can happen when people do what they're doing. Explain that it doesn't always happen, but it only has to happen once...


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