Bacterial Contamination of Contact Lens Cases and Non-Compliance behaviors of Soft Contact Lenses Wearers in Palestine
Publication Type
Conference Paper
Authors

SIGNIFICANCE: Non-compliance is common among contact lens wearers, and it is considered as a challenge for eye care practitioners. Contaminated lens case acts as a reservoir for microorganisms and accounts for serious complications and discomfort. The most severe complication is microbial keratitis which could lead to corneal ulcer, severe visual impairment and public health consequences. Factors such as laziness, increasing costs and poor understanding of instructions are likely to be contributors of poor compliance. PURPOSE: In order to improve compliance, it is essential to assess the level of compliance, hygiene behaviours and reasons of non-compliance. This study was conducted to evaluate the level of lens wearers’ compliance, the behaviors which have the highest levels of non-compliance, factors that lead to lens case bacterial contamination and to study the causes of lens wearers’ non-compliance. METHODS: The participants were interviewed to answer a survey questionnaire which collected information regarding contact lens (CL) wearer demographic, detailed declaration of their CL usage, CL disinfecting solution use, behaviors and reasons of non-compliance. Additionally, a sample from the participant’s lens case was collected and tested against bacterial contamination using standard methods. RESULTS: All study participants (133) were non-compliant. The aspects of lens care behaviours displaying the highest non-compliance were: re-disinfecting the lenses if they were left in storage case for longer than indicated (92%); lens case cleaning (84%); lens case replacement (66%); rubbing and rinsing the lenses before handling (62%); and topping up care solutions (56%). Additionally, it was found that 18.8% of the participants had their lens cases contaminated by microorganisms. Potential pathogens for keratitis, such as Staphylococcus Aureus (5.2%), Pseudomonas Aeruginosa (2.5%) and Serratia Marcescens (2.4%) were found. The aspects of lens care procedures which showed a statistically significant impact on inducing bacterial contamination were; topping up care solution (P = 0.03), poor hands hygiene (P = 0.04), swimming and showering (P = 0.01), lens case replacement (P = 0.01) and poor lens case cleaning (P = 0.04). Furthermore, the causes of non-compliance which were related to bacterial contamination, in this study, were insufficient care instructions and to save money (P ≤ 0.05). CONCLUSIONS: All participants showed some degree of non-compliance. The poorest levels of compliance were mostly associated with disinfecting lenses, replacing lens case and topping up care solution. Non-compliance was associated with storage case bacterial contamination which was mainly attributed to non-compliance in storage case care procedures. Insufficient care instructions and saving money were the main reasons of non-compliance in this study.

Conference
Conference Title
• 5th Jordanian Palestinian Optometry Conference
Conference Country
Palestine
Conference Date
March 7, 2019 - March 8, 2019
Conference Sponsor
نقابة اختصاصيي البصريات الفلسطينية والأردنية