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S P E C I A L E D I T I O N 2 0 1 5 • O P T O M E T R I C M A N A G E M E N T . C O M 37 I NNOVATION CAN come from any- where, at anytime. Ofen times, it comes from someone noticing a gap in the market, looking to fll an unmet need, a frustration, or from the desire to improve something. It all starts with an idea born from these inspirational motivating factors. For example, drive-thru windows at fast-food restaurants were born out of the need to eat on limited time. In the contact lens industry, dry eye dis- ease (DED) has been one of the driving forces behind innovations in materials and designs. Here, I explain why and how we, as optometrists, must step up to ensure our contact lens-wearing patients re- main in their lenses. WHY Every year there is a growth rate of about 16% for new contact lens wear- ers, but the market stays fat because an even number of patients dropout annually at the same time. Te num- ber one reason for this is discomfort. And guess what — a great deal of this discomfort is due to untreated ocular surface disease, primarily DED. In fact, recent increases in DED re- search has elevated the awareness and understanding about the condition to an all-time high in contact lens com- panies. Tis has led to the frestorm of innovation we have seen recently in the creation of advanced technology contact lenses aimed at stopping con- tact lens dropouts. Daily disposable contact lenses made of silicone hydrogel, in par- ticular, have been the focus of con- tact lens companies because both the modality and material allow them to be extremely comfortable, while being breathable to ensure optimal corneal health and thus, prevent contact lens dropout. OUR ROLE Despite the research and innova- tions in contact lens technologies, we, as optometrists, are not actively look- ing for and managing DED. In fact, 52.7% of contact lens wearers report symptoms of ocular dryness. Do we treat 52.7% of our contact lens patients for DED? As a profession, I don't think we get anywhere close to that number. When I frst began practicing, I ignored DED. I didn't think it was im- portant. I would ofer patients two or three diferent artifcial tear samples and say, "See you again in a year." About fve years into my career, however, I attended a lecture about DED that challenged my opinion on the condition. In fact, it made me feel uncomfortable, as I realized I had been ignoring DED and not practic- ing to the highest standard of care. I knew that I had to learn more about DED and stay abreast of current treat- ments. Tis led me to read everything I could get my hands on, such as the DEWS report. Soon, I adopted the International Task Force Guidelines to assess and treat dry eye patients. Tis shif in the way I practiced has helped my practice tremendously, es- pecially when it comes to my contact lens-wearing patients. STEP UP TO THE PLATE TO PREVENT CONTACT LENS DROPOUT, YOU MUST BE AN INNOVATOR IN CARE Above, a two-week contact lens pa- tient with superior punctate keratitis from untreated dry eye. This patient was diagnosed with dry eye and then treated with artifcial tears PRN and cyclosporine BID OU for two weeks prior to switching modalities to a daily contact lens, which gave her improved comfort and wear time. This patient presented wearing a monthly contact lens and complained of discomfort and having to remove his contacts after six hours of wear. He was diagnosed with meibomian gland dysfunction and dry eye and was prescribed lid hygiene QD, warm compresses QD, Omega's PO, artifcial tears PRN, cyclosporine BID OU, and a combination topical steroid/antibiotic drop BID OU x 2 weeks. After treating the meibomian gland disease and dry eye for four weeks, he was then reft in a daily contact lens, giving him better comfort and increased wear time. Continued on p. 52 CLINICAL ANTERIOR