Battling Contact Lens Intolerance

Avenova is part of a combination strategy for healthy contact lens wear

DAVID A. GOLDMAN, MD

How big an issue is contact lens intolerance? When NovaBay asked a group of physicians to discuss this question, I learned it’s a bigger problem than I thought. Patients show poor compliance, wearing daily disposables for a week and extended-wear lenses for who knows how long. It’s horrifying.

The result is an accumulation of mucin, oil, and bacteria on the contact lens, particularly in younger patients. This accumulated junk results in what our group calls the “suffocated cornea.” It becomes hypoxic. Limbal stem cell issues develop. We see peripheral, marginal keratitis that can involve the central cornea.

How Avenova Helps

We know that when contact lens patients use Avenova, they are removing bacteria and their toxins. Avenova also helps patients better tolerate their contact lenses by improving signs and symptoms of meibomian gland dysfunction (MGD) and dry eye.

When our group of physicians discussed the best treatment for MGD and dry eye, the consensus was that it’s best to use Avenova in combination with other products. For example, all of these patients get omega-3s. Also, in my practice, I have noted a synergistic response with Avenova and cyclosporine (Restasis, Allergan). I think that when both treatments are used together, I see a faster, more effective result. Azithromycin (AzaSite, Akorn) is an option to use in combination with Avenova as well.

To open up the meibomian glands by melting the secretions, we use intense pulsed light treatment (IPL) in my practice, while some practices use LipiFlow (TearScience). In my experience, when meibomian glands are blocked, Avenova will decrease bacteria but not symptoms.

Once we use a therapy, such as IPL, to improve function of the meibomian glands, Avenova can work better and extend the decreased symptoms. BlephEx (Rysurg), another treatment used by some optometrists, helps remove biofilm on the lid margin to improve function.

How Patients Can Help Themselves

Blepharitis waxes and wanes, but it never gets better. It is a chronic problem that needs daily management. That means that patients will only feel better if they comply with a regimen at home. How can we increase their compliance with proper use of Avenova?

To begin, we need to educate physicians and clinicians about the need for continuous therapy. NovaBay frames this explanation with the dental hygiene model. For people with chronic MGD, dry eye, or contact lens intolerance, eyelid hygiene is a daily necessity. Just as you get a dental cleaning every six months and brush your teeth twice a day, you need to have IPL or LipiFlow in the office and then use Avenova every day at home.

In addition to getting physicians on board, we can fall back on some of Avenova’s inherent qualities to enhance compliance. We’ve all seen patients who have “tried everything” finally get relief when they use Avenova, and we can count on those patients to be compliant. Avenova is an affordable treatment, so money is generally not a compliance factor.

A final advantage is the fact that Avenova is a prescription product. Patients can buy over-the-counter products for eyelid cleansing. We know that they won’t get the same results from these products, which is why I write them a prescription. Patients understand that, and they trust prescription products, such as Avenova, to be more potent and effective.