BCLA Pioneers Lecture - evidence basis for patient selection: how to predict contact lens success.

A prediction (Latin præ-, "before," and dicere, "to say") or forecast can be defined as “a statement about the way things will happen in the future, often but not always based on experience or knowledge. Although guaranteed information about the future is in many cases impossible, prediction is necessary to allow plans to be made about possible developments” (Wikipedia). Some predictions in the field of contact lenses have been very high profile and controversial, such as the predicted demise in rigid gas permeable contact lenses (RGPs) by Nathan Efron, whereas others, such as the presumed safety of multipurpose contact lens care solutions that have met specified regulatory criteria, have proved disastrously wrong (resulting in the Fusarium outbreak). However, as eye care practitioners, it is important that we use the evidence from studies to predict patient outcomes. This will reduce their risk of complications, aid in early diagnosis and allow patients to achieve the best possible refractive correction and management of their symptoms first time. Noninformed selection of visual correction such as a multifocal contact lens design, or treatment such as a tear supplement for dry eye, must lead to less than possible satisfaction in many patients. It is surmised that this leads to contact lens drop-out and patients living with suboptimal vision and comfort due to the perception that ‘the’ treatment doesn’t work.