The critical initial comfort of soft contact lenses

Abstract

Background: The initial comfort of soft lenses is not as important when prospective patients are highly motivated to be fitted with contact lenses but can be critical in the case of apprehensive patients, especially in the case of proactive demonstration/diagnostic fittings. Failure to eliminate initial discomfort may cause apprehensive prospective contact lens wearers to decide not to proceed with a fitting. However, in all cases of clinical and research fittings, initial comfort is critical to fit evaluation, when abnormal lid tonus and lacrimation can invalidate assessment. Method: A panel of experienced contact lens practitioners evaluated three methods of lens settling that could be employed to improve soft lens comfort immediately after lens insertion. Results: A total of 1,234 lens insertion experiences were examined by the panel and it was found that soft lens settling procedures were indicated in 46 per cent of cases. The settling procedure was found to be successful in 86 per cent of cases. The temporal lens displacement method of soft lens settling was found to be easier to use (p < 0.001) and the lens displacement away from the perceived location of irritation method was found to be the most successful (p < 0.05). Conclusion: In cases of mild to moderate discomfort, the displacement away from irritation method had a better chance of establishing comfort and was the most appropriate method to teach patients to use when inserting lenses for themselves. This study also indicates that, under certain conditions, the location of corneal sensation may be much better than previously found.