What have we learned from the Fusarium outbreak? Last year's Fusarium keratitis outbreak generated renewed interest in the importance of lens care compliance. Here's how this outbreak changed the way O.D.s educate their patients.

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Proper contact lens care and patient compliance--with lens care instructions, recommended lens replacement schedules and follow-up care--has always been considered important in optometric practice. Nevertheless, as many as 32% to 80% of patients do not totally comply with their doctor's instructions. (1-15)

However, last year's Fusarium keratitis outbreak--which resulted in 164 confirmed cases by the Centers for Disease Control and Prevention (CDC) in 33 states and one United States territory--generated a renewed interest in the importance of compliance to lens care. (16) Bausch & Lomb's withdrawal of ReNu MoistureLoc formula from the market--used exclusively in 57% of these cases (with possible use in many other cases)--has obviously impacted the incidence of this condition.

This outbreak focused attention on the fundamental issue of convenience vs. compliance with the prescribed care regimen and care instructions. Consumers are increasingly interested in the convenience and price of private label solutions. In a recent study by Jobson Research, the fact that contact lenses were considered a "hassle" was the second most common reason (next to discomfort) for discontinuation of lens wear by the 1,232 respondents to this survey. (17)

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Indeed, factors implicated in the outbreak of Fusarium keratitis--in addition to a possible interaction between the MoistureLoc formula and the contact lenses and lens case--included the omission of important steps in the care process: (18)

1. Not using fresh solution every day.

2. Not rubbing the lenses after removal.

3. Not adhering to recommended replacement schedule and over-wearing lenses.

(Take note that ReNu MultiPlus retained a high level of biocidal activity under the same conditions.)

Therefore, we're left with one obvious question: Has this outbreak changed how practitioners and their employees educate their patients about contact lens care?

The Big Question

I posed this question to the 55-member Advisory Committee of the GP Lens Institute (GPLI). The GPLI is the educational division of the Contact Lens Manufacturers Association. This group of practitioners was selected to participate due to their reputation as experts in the contact lens industry with expertise in all types of contact lens materials (soft and GP) and designs.

Specifically, they answered the following question: "Have you made any changes in how you educate contact lens patients since the Fusarium keratitis outbreak (i.e., educational materials, case replacement, importance of compliance, etc.)? Why or why not?"

Of the 55 members, 27 members (49.1%) responded to this one-question e-mail survey--their names are listed at the end of this article. Of these respondents, 15 (55.5%) indicated that they had changed how they educate their patients. The remaining 12 (44.4%) indicated that they made no change in how they approached patients.

A common response from those practitioners who changed how they approached patients: They did not necessarily change the information they presented; rather, they changed the emphasis of what they presented.