Like many of you, more than one-third of my income comes from fitting and dispensing contact lenses. So, you can imagine my concern when I read that 2.7 million Americans dropped out of contact lenses in 2002 alone, according to the Centre for Contact Lens Research at University of Waterloo College of Optometry. I wanted to know why these dropouts occur and how to prevent them.

Thats what our 28th Annual Contact Lens Report is all about. Well look at why patients discontinue lens wear and what we, as O.D.s, can do. This special report includes these sections:

Whats Driving the Dropouts?. Associate Editor Jennifer Kirby offers an in-depth look at the statistics behind contact lens dropouts. Knowledge of why patients discontinue contact lens wear is the first step toward preventing future dropouts and perhaps recapturing previously unsuccessful wearers.

A Four-Step Approach To Preventing Dropouts. Managing Editor Jeffrey S. Eisenberg gathers clinical pearls from your colleagues. Learn how the S.O.A.P. exam format (subjective, objective, assessment and plan) can help you uncover underlying comfort or vision issues that have patients ready to return to spectacles or seek refractive surgery.

Case Reports. Associate Editor Michelle Boyles asked your colleagues to share several cases that illustrate how to prevent dropouts. First, Heather Cowden, O.D., discusses how a rigid lens can help when a patients LASIK Evaluation Uncovers Degeneration. Next, Patricia Keech, O.D., discusses why Material Does Matter when dryness and deposits prevent successful contact lens wear.

Finally, Susan Resnick, O.D., offers A Useful Approach for Keratoconus, in which she demonstrates how the right material helped a patient who had all but given up on wearing contact lenses. Dr. Resnick also discusses High Dk for Dry Eye to address the principle reason patients discontinue contact lens wear. She also explains how she went From Monovision to Multifocal to help a presbyopic patient achieve better vision.

Whose Fault?
My mentor, optometrist Robert J. Morrison, used to say, If you cant wear a contact lens, its probably your doctors fault.

If a patient is thoroughly and properly screened, excluding everyone who should not wear or attempt to wear contact lenses, and we use all the available materials and designs that we have today, hes probably right.

Some suggestions:

Get up-to-date exam equipment. We want to ensure that there is no lid disease and that the patient is a contact lens candidate.

Choose a lens that centers well on the eye and can sufficiently flush out debris.

Stock your dispensary with an array of options.

Proactively encourage contact lens dropouts to come to your practice. Let patients know that we are the problem solvers.

We cannot make every patient happy, nor can we resurrect every dropout. However, by addressing these issues and following the suggestions of our colleagues over the next several pages, we can retain and reinvigorate a large portion of patients who are essential to the success of our practices.