Primary preventive care refers to a number of measures taken to reduce the risk of disease or injury. Effective preventive care starts with patient education.  Without question, preventive care is imperative in optometry. Our contact lens patients rely upon us to provide them with specific instructions on how to maintain good ocular health and avoid complications.

Preventive care is critical when prescribing a contact lens regimen. While you must consider many factors, the most important goal is to prevent contact lens-related microbial keratitis. True, poor patient compliance and lens hygiene are often associated with contact lens-related infections. Some patients who demonstrate proper lens care and hygiene practices are not completely immune to the risk of infection.¹ Bottom line––we instill preventive care by educating our patients and providing them with the products we believe will be best for  them.

Broad-spectrum microbial disinfection is essential in the prevention of microbial keratitis. Because there are numerous pathogens potentially responsible for contact lens-related infection, it is important to provide disinfection that is efficacious against bacteria, fungus and Acanthamoeba.^2,3

Polyhexamethylene biguanide (PHMB) is utilized as the sole disinfecting agent in numerous multipurpose solutions. However, OPTI-FREE® RepleniSH® contact lens solution features a complimentary dual disinfection system that contains of both POLYQUAD® and ALDOX® antimicrobials, which broadens its spectrum of activity. POLYQUAD® antimicrobial specifically targets bacteria, as well as provides some antimicrobial activity against fungus and Acanthamoeba.⁴ The addition of the ALDOX® antifungal agent in OPTI-FREE® RepleniSH® compliments the activity of POLYQUAD® and provides increased efficacy against fungus and Acanthamoeba.^5-7 ALDOX® and POLYQUAD® antimicrobials work together synergistically to provide comprehensive disinfection that actually exceeds the requirements set forth by the FDA and the International Organization for Standardization.⁶  

Contact lens storage cases have been cited as a probable source of microorganisms that cause microbial keratitis.⁸ Contamination of the contact lens storage case has been found to occur in 30% to 80% of all contact lens wearers.⁹ With such a high risk of contamination, it makes sense that the solution used to disinfect and store lenses should maintain maximum potency during storage. Most contact lens wearers store their lenses for at least six to eight hours. Some disinfection systems are unable to retard microbial regrowth during lens storage.¹⁰ However, OPTI-FREE® RepleniSH® MPDS maintains disinfection during prolonged storage.

Preventive care to avoid microbial keratitis begins with prescribing the proper contact lens solution. OPTI-FREE® RepleniSH® MPDS consists of a complimentary dual disinfection system that is designed to provide high-level antimicrobial efficacy against bacteria, fungi and Acanthamoeba while maintaining full potency during prolonged lens storage. Keeping your patients healthy and preventing serious consequences is the best care that you could possibly provide.

This column is sponsored by Alcon.

1. Najjar DM, Aktan SC, Rapuano CJ, et al. Contact lens-related corneal ulcers in compliant patients.  Am J Ophthalmol.  2004 Jan;137(1):170-2.
2. Fleiszig SM. The pathogenisis of contact lens-related keratitis.  Optom Vis Sci. 2006 Dec;83(12):866-73.
3. Stapleton F, OzkanJ, Jalbert I, et al. Contact lens–related Acanthamoeba keratitis. Optom Vis Sci. 2009 Sep 7.
4. Santodomingo-Rubio J. The comparative clinical performance of a new polyhexamethylene bigaunide vs. a polyquad-based contact lens care reime with two silicon hydrogel contact lenses. Opthalmic Physiol Opt. 2007 Mar; 27(2):168-73.
5. Rosenthal RA, McAnally CL, McNamee LS, et al. Broad-spectrum antimicrobial activity of a new multi-purpose disinfecting solution. CLAO J. 2000 Jul;26(3):120-6.
6. Rosenthal RA, Bell WM, Henry CL, et al. Antimicrobial spectrum of a new contact lens disinfectant. Poster presented at American Academy of Optometry’s Annual Meeting, San Diego, CA: December, 2005.
7. Codling CE, Maillard J, Russell AD. Aspects of the antimicrobial mechanisms of a polyquaternium and amidoamide. J Antimicrob Chemother. 2003 May; 51(5):1153
8. Gray TB, Cursons RT, Sherwan JF, Rose PR. Acanthamoeba, bacterial and fungal contamination of contact lens storage cases.  Br J Ophthalmol. 1995 June;79(6):601-5.
9. Wu YT, Zhu H, Harmis NY, et al. Profile an dfrequency of microbial contamination of contact lens cases. Optom Vis Sci. 2010 Jan 22.
10. Rosenthal RA, Buck S, McAnally C, et al. Antimicrobial comparison of a new multi-purpose disinfecting solution to a 3% hydrogen peroxide system. CLAO J. 1999 Oct;25(4):213-7.