Topical anaesthetic use prior to rigid gas permeable contact lens fitting

To investigate effect of topical anaesthetic (TA) during gas permeable (GP) contact lens (CL) fitting on subjective and objective measures of patient anxiety.

47 subjects (mean±sd age=26.9±4.9years; soft CL wearers, 18, neophytes, 29). Each subject randomly assigned to Group A or B, and attended on two occasions, one week apart. First visit: subject received bilaterally either a single drop of TA (0.5% proxymetacaine) (Group A) or placebo (0.9% saline) (Group B) prior to GP CL application. No drops were instilled at second visit. Each visit mimicked a GP CL fitting. At each visit, patient anxiety was assessed either subjectively (visual analogue scale (VAS)) or objectively (skin conductance (SC)), as well as anterior ocular health.

Visit 1: GP CL trial produced small increases in hyperaemia and corneal staining, but no difference associated with TA use. Visit 2: increases in staining and hyperaemia were observed, but hyperaemic responses significantly less than at Visit 1, for both groups. Corneal staining also less, but not statistically significant. VAS scores indicated subjects who received TA during Visit 1 were significantly less anxious at Visit 2. Visit 2: comfort slightly reduced for subjects who received TA at Visit 1, and significantly increased for subjects who received placebo. Use of TA reduced anxiety during lens adaptation period compared with subjects receiving placebo.

TA use during GP CL fitting has potential patient benefits: improved first-time GP CL wear comfort, reduced anxiety during adaptation, reduced anxiety prior to subsequent GP CL wear.