At a recent Sydney event, hosted by Bausch and Lomb, eye care professionals gathered to hear insights into managing dry eye disease and enhancing patient outcomes with the Ultra One Day contact lens.
The continuing professional education event featured presentations from dry eye expert and academic, Dr Maria Markoulli; optometrist Narelle Hine from HineSight and Narelle Hine Optometrist; and Simon Hanna, the National Professional Service Manager with Bausch and Lomb.
Addressing Dropout and Dry Eye
In his presentation, Mr Hanna highlighted a troubling statistic: 40% of contact lens wearers report a history of dropout, with discomfort and dryness being the top reasons.
“This is a real issue for them and ultimately for you as optometrists,” he said, challenging practitioners to reclaim their prescribing authority.
While dry eye, historically, has been a contraindication for contact lens wear, he emphasised the Ultra One Day lens’ ComfortFeel technology, which infuses osmo-protectants and potassium chloride into the lens, through the packaging solution, to improve ocular surface homeostasis. He described this as being particularly beneficial for patients at risk of contact lens dropout due to dry eye symptoms.
Scientific Backing for Clinical Practice
Dr Markoulli reinforced the importance of evidence-based prescribing, referencing systematic reviews and randomised control trials on tear supplements and biological treatments.
“One increasingly clear phenomenon is that combination products perform better than single polymer products,” she noted.
Dr Markoulli said there were a lot of available dry eye products that worked “at least in one shape or form”, however “because of the plethora of options… patients often face this ‘trial and error’ approach, leading to significant cost to them and frustration both for them and for us”.
“Also, because we have a lack of these published head-to-head studies, we don’t really know if product A versus product B is better.
“What we do know is that combination formulations… work better than single active ingredients. What we also know is that patients who have evaporative dry eye… benefit from supplements that have lipid within them.
“In terms of dosage and duration, what we know from systematic reviews is that symptoms take up to at least a month to improve when the lubricants are used four times a day, whereas signs take up to four months to improve. And this is really important, because it impacts what we say to our patients. If there’s no improvement after a month of using this four times a day, then fine, move on to another supplement. Having said that, the corollary here is that if you want to see if this works, you need to try it for at least a month, and four times a day.”
Ms Hine shared a six-point data collection strategy, including assessing pupil size and the sensory dominant eye for distance and near, and the primary vision need from contact lenses.
Real-World Application in the Chair
Ms Hine shared clinical cases from her Sydney CBD practice, where complex fits are the norm. She praised the Ultra One Day’s simplified fitting guide for multifocals and consistent visual performance. “Patients all gave higher comfort scores despite their low tear volume compared to the lenses they had been wearing earlier,” she said.
Ms Hine shared a six-point data collection strategy, including assessing pupil size and the sensory dominant eye for distance and near, and the primary vision need from contact lenses.
For optometrists, the key takeaways were the need to lead the multifocal conversation, to optimise the tear film, and to embrace innovative lens designs. These are all critical in combating dropout and growing a successful contact lens practice.
