title: Lens wearers non-compliance - is there an association with lens case contamination?
abstract: OBJECTIVE
  This study aims to investigate the association of compliance amongst lens wearers and lens case contamination as assessed by the microbial profile of lens cases.
  
  
  METHODS
  Fifty-two asymptomatic lens wearers filled out questionnaires seeking demographic data and several aspects of compliance to lens wear. Subsequently, contamination profiles of the inside bottom and rim of their lens cases was obtained for bacteria, fungi and Acanthamoeba. The association of the self-reported responses in the questionnaire with contamination profile of the lens case was then analyzed.
  
  
  RESULTS
  Based on compliance criteria, 21% of the participants were described as fully compliant lens wearers. Contamination of lens case was prevalent in 42% of the cases. Frequent non-compliant behaviours reported by study participants included, showering and sleeping with contact lenses, and irregular lens case replacement. In comparison to soft contact lens wearers prevalence of non-compliance and contamination amongst rigid gas permeable (RGP) lens wearers was significantly greater. There was a statistically significant correlation between bacterial contamination and current case age.
  
  
  CONCLUSIONS
  These results suggest that majority of lens wearers do not fully comply with recommendations for lens wear and case care. Crucially, none of the fully compliant patients had contaminated lens cases. However it would appear that several non-compliant behaviours significantly increase the risks of case contamination. These results suggest that greater efforts should be invested with lens wearers to ensure enhanced compliance as this is likely to reduce the possibility of case contamination.
authors.affiliation: Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia. Electronic address: tomislav.kuzman@kbc-zagreb.hr.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Kuzman
authors.affiliation: Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia.
authors.forename: Marija Barišić
authors.initials: MB
authors.lastname: Kutija
authors.affiliation: Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Juri
authors.affiliation: Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia.
authors.forename: Sonja
authors.initials: S
authors.lastname: Jandroković
authors.affiliation: Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Skegro
authors.affiliation: Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia.
authors.forename: Sanja Masnec
authors.initials: SM
authors.lastname: Olujić
authors.affiliation: Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia.
authors.forename: Rajko
authors.initials: R
authors.lastname: Kordić
authors.affiliation: Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia.
authors.forename: Branimir
authors.initials: B
authors.lastname: Cerovski
mesh_terms: D000328:Adult; D001419:Bacteria / Q000302:isolation & purification*; D003261:Contact Lenses / Q000009:adverse effects* / Q000382:microbiology*; D004866:Equipment Contamination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D017060:Patient Satisfaction; D019064:Product Packaging; D013223:Statistics as Topic
keywords: Case contamination; Case replacement; Compliance; Contact lens; Non-compliance