Noncompliant Contact Lens Practices Reveal Need For Education, Intervention

Improved education and interventions may change perceptions of minimal benefit and larger barriers to complying with contact lens wear instructions.

More than one-fifth of daily disposable soft contact lens wearers report noncompliant wearing behaviors, according to research published in Ophthalmic and Physiological Optics. Correlations between these behaviors and Health Belief Model (HBM) constructs indicate a need for improved patient education and interventions, the report suggests.

Researchers included 100 participants from 2 sites (76% women; mean age, 24.2 years) in the investigation. The research team administered a verbal questionnaire to collect demographic data and participants completed an electronic survey to report attitudes and beliefs toward their daily contact lens wear. Participant responses were examined for associations with HBM constructs, which include perceptions of susceptibility, severity, benefits, barriers, cues to action, and self-efficacy.  

Overall, 37% of participants reported sleeping in their contact lenses and nearly one-third of these individuals did so with a frequency of once per week or more. A total of 25% of participants reported reusing the lenses. Over half of these participants did so once per week or more — and when they were reused, half of these individuals reported wearing them for 2 or more additional days. 

Reusing the contact lenses was associated with lower HBM benefit (P =.02) and higher barrier (P =.007) subscale scores. Sleeping in the lenses was also associated with lower benefit (P =.006), and higher barrier (P =.01) scores. According to the report, these correlations indicate that individuals who sleep in or reuse their lenses are more likely to perceive less benefit and more barriers to following lens wear and care guidelines.

Increased understanding of [daily disposable soft contact lenses] attitudes and beliefs could further inform patient education and interventions to reduce the risk of adverse events.

However, individuals who slept in their lenses also scored high on the susceptibility construct (P =.05), indicating a perception of increased susceptibility to adverse contact lens-related events.  

Education level was significantly associated with perceived benefits (P =.004), perceived barriers (P =.04) and self-efficacy (P =.05) scores. Participants without a college education perceived more benefit and less barriers to following recommended guidelines compared with individuals who were college-educated, the report states.

Contact lens wear is widely considered to be a safe and effective way to manage refractive error. However, adverse events still occur and are more likely with improper use,” according to the researchers. “Increased understanding of [daily disposable soft contact lens] attitudes and beliefs could further inform patient education and interventions to reduce the risk of adverse events.”

Study limitations include the use of convenience sampling and a limited number of participants without a college education. 

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please see the original reference for a full list of authors’ disclosures.


Lutmer KM, Wagner H, Richdale K, Zimmerman AB, Datta A, Dougherty BE. Examining daily disposable soft contact lens wearers’ attitudes and beliefs using the Health Belief Model. Ophthalmic Physiol Opt. Published online December 4, 2022. doi:10.1111/opo.13078