How should I handle poor initial wettability?
“There is a large segment of contact lens wearers who are female and either menopausal or post-menopausal. Hormonal shifts can certainly impact tear chemistry and result in decreased surface wettability, even if this has not been a problem with previous lenses. In addition, be sure to determine what medications they are taking and determine if this could be impacting their tear quality and volume. Also, be sure to always inform patients to use any creams or perfumes after lens insertion.” (Keith Parker, Advanced Vision Technologies)
“When this occurs, it is often as a result of either the patient or the staff member checking in the lenses using a hand cream or soft soap; these can have lanolin or emollients such as coconut oil that can leave a residue on the surface.” (Mike Johnson, Art Optical)
“Poor initial wettability can result from lack of proper cleaning and conditioning prior to dispensing. There is also the possibility of transfer of releasing agents to the contact lens surface when lenses are dry-shipped. For this reason, most labs offer and encourage the option of having lenses wet-shipped to your office.” (Alika Mackley NCLE-AC, ABB Optical Group)
“Poor wettability is a problem consultants often run into. The number one thing that can be done to solve this problem is asking the right questions. There are so many factors that can affect wettability, including materials, patient hygiene, cleaning regimen, environment, and even the lens case. You must get information on these things to choose the best option for solving the problem.” (Derrell James, X-Cel)
If poor wettability occurs over time, what should I do?
(A list of GP solutions is available on this website.)
“This is often a result of patient tear chemistry/volume issues related to age. The best resolution for these patients is to incorporate Tangible Hydra-PEG surface coating. It is highly effective in resolving wetting issues.” (Mike Johnson, Art Optical)
“The first step is to ensure the patient is following the proper cleaning, handling, and care regimen for the lenses. If the patient has dry eyes, produces excess mucins, or has other clinical reasons for inhibiting wettability, we recommend using Tangible Hydra-PEG coatings.” (Derrell James, X-Cel)
“We recommend Tangible Hydra-PEG be added to lenses for patients experiencing comfort and wettability issues. This polymer coating is available on GP and hybrid lenses.” (Bernie Ferguson, SynergEyes)
“Review the patient’s care regimen, hand soaps, creams, lotions, and cosmetics. Have the patient use a multi-step solution system rather than a one-step system. Verify that the patient cleans the lenses on removal at night, conditions them overnight, and does not rinse off the conditioning solution before insertion. Make sure that the patient is not using a hand soap with moisturizers and that they wash their hands prior to removing lenses from the case and inserting them. Wettability issues tend to be more prevalent during the winter, when people are more likely to use lotions to alleviate dry skin problems.” (Alika Mackley NCLE-AC, ABB Optical Group)
“Upon removal, the use of an effective and compatible in-office cleaner is helpful, followed by the use of a conditioning solution that can be rubbed into the surface of the lens. In the morning, the lens should be removed directly from the case and inserted. Rinsing at that time could negate the effect of conditioning and impact wettability and comfort. In addition, if the lenses are shipped in the wet state, this is beneficial in optimizing both sterility and initial wettability. If shipped in the dry state, the lenses should be soaked, at minimum, for four hours in conditioning solution prior to dispensing.” (Janice Adams, Valley Contax)
“Confirm that your patient is using sterile saline for rinsing their contact lenses rather than tap water. Although hybrid lenses have a gas permeable component, we recommend the use of soft contact lens care systems, with a digital rub prior to storage, to keep the lens surface clean and wettable.” (Connie Adam, SynergEyes)