Clinical Scorecard: Contact Lenses: Directing Wear in Diabetes

At a Glance

Key Highlights

• Single-use lenses are preferred for diabetic patients to reduce infection risk.
• Patients should not wear lenses for more than 12 hours to prevent complications.
• Comprehensive ocular surface evaluations are essential before fitting lenses.
• Higher hemoglobin A1C levels correlate with increased dry eye disease symptoms.
• Regular follow-up appointments are crucial based on ocular health and lens wear habits.

Guideline-Based Recommendations

Diagnosis

• Perform slit lamp evaluation with vital dyes.
• Measure tear film break-up time and analyze tear prism thickness.

Management

• Prescribe single-use contact lenses and educate on hygiene practices.
• Delay or deny fitting if dry eye disease is present until treatment is effective.

Monitoring & Follow-up

• Establish a recall schedule based on diabetes severity and ocular health.
• Conduct semi-annual progress checks for patients with excellent ocular health.

Risks

• Increased risk of microbial keratitis from improper lens hygiene.
• Potential for neurotrophic keratitis due to reduced oxygen to the cornea.

Patient & Prescribing Data

Patients with diabetes, particularly those with type 2 diabetes.

Educate patients on the importance of lens hygiene and the risks of extended wear.

Clinical Best Practices

• Always educate patients on the risks associated with contact lens wear in diabetes.
• Encourage handwashing before lens handling.
• Monitor and address dry eye symptoms proactively.

References

• Zhang et al. 2016
• Stellwagen et al. 2020