Noncompliance with lens care has been shown to be associated with contact lens–related complications, likely because of increased bacterial bioburden at the ocular surface, and symptoms of lens discomfort and reduced performance, which ultimately contributes to nonadaptation and the persistent contact lens dropout rate. The benefits of increasing patient compliance are clear.

2, 9 To date, there is no single predictor for noncompliance among contact lens wearers, 6 and despite the introduction of daily disposable lens wear and one-step “no-rub” multipurpose disinfection systems, compliance with contact lens wear remains an ongoing clinical problem. 8 The ability to assess compliance in these studies is further clouded by the fact that many patients are unaware that their contact lens wear and care practices are reflective of a noncompliant behavior. 2– 7 More recently, a study in the United Kingdom reported that for daily lens wearers, only 0.3% of patients were fully compliant compared with 2.7% for extended lens wearers. In the contact lens field, numerous studies have attempted to evaluate compliance, many using self-reported written questionnaires, which have generated estimates of noncompliance ranging from 40% to 91%. Establishing true levels of compliance, however, is fraught with error because there is no testable direct quantitative measure of compliance. To improve compliance, the rate of actual compliance must first be determined. 1 Although factors driving noncompliant behavior are poorly understood, the economics, time requirements, and regimen complexity are all likely contributors. Within the health care field, noncompliance with prescribed medical regimens accounts for a significant increase in health care expenditures and disease morbidity, necessitating increased physician time and additional interventional treatments.

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