title: Non-compliance with contact lens wear and care practices: a comparative analysis.
abstract: OBJECTIVE
  To compare the effects of existing patient awareness of lens-related complications and underlying risk factors on actual patient behavior during contact lens wear and care practices in two different clinical study populations.
  
  
  METHODS
  Established contact lens wearers (n = 281) completed an anonymous written questionnaire on presenting to their habitual eye care practitioner in the Dallas-Fort Worth metroplex. Data were analyzed and compared against a second study population, which comprised established contact lens wearers (n = 152) who were sequentially evaluated after their routine contact lens examination at the University of Texas Southwestern Medical Center at Dallas, TX (UTSW). All patients were questioned regarding his or her lens care practices and knowledge of complications and risk factors associated with contact lens wear.
  
  
  RESULTS
  Fifty-eight percent of patients in the general community could identify by name a complication associated with lens wear compared with 91% within the medical center. The most frequent complications reported were related to comfort and handling (72%, Dallas-Fort Worth) and infection (47%, UTSW). The majority of patients could correctly identify risk factors associated with lens-related complications; awareness for topping-off solutions, tap water exposure, and hygiene varied between groups. Overall, 85% of patients perceived themselves as compliant with their lens wear and care practices. Using a standard scoring model to determine actual compliance, 2% of patients demonstrated good compliance; however, only 0.4% of patients were fully compliant with contact lens wear and care practices.
  
  
  CONCLUSIONS
  The data reveal some study bias in complication and risk awareness between populations; however, despite this limitation, a significant proportion of patients exhibited actual non-compliant behavior despite acknowledged awareness of risk. Although most patients consider themselves to be complying with standard practitioner guidelines for lens wear and care practices, essentially all contact lens wearing patients exhibit behavioral non-compliance with resulting increased risk for significant complications.
authors.affiliation: The Department of Ophthalmology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9057, USA. Danielle.Robertson@utsouthwestern.edu
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Robertson
authors.forename: H Dwight
authors.initials: HD
authors.lastname: Cavanagh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018639:Contact Lens Solutions; D003261:Contact Lenses; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018639:Contact Lens Solutions