Value of routine evaluation in asymptomatic soft contact lens wearers

•Many subjectively asymptomatic soft contact lens wearers (51%) have undiagnosed ocular and systemic health complications.•“Successful” soft lens wearers carry a substantial number of contact lens design and hygiene issues.•The continued importance of routine professional examination for even asymptomatic contact lens wearers is supported. Limited literature supports the value of routine contact lens examinations. The purpose of this study is to document complications diagnosed when subjectively successful planned replacement soft contact lens patients are evaluated to renew their existing contact lens prescriptions. Asymptomatic soft contact lens patients who presented to the University Eye Center at Ketchum Health (Anaheim, CA) and the Eye and Vision Center at the Massachusetts College of Pharmacy and Health Sciences (Worcester, MA) for routine contact lens comprehensive exams to renew existing contact lens prescriptions were professionally evaluated and their complications documented. All subjects presented without complaint and had a history of subjectively successful planned replacement soft lens wear for at least 1 year. A total of 202 subjects were recruited from both sites (age range 16–72 years; 76 male, 126 female; spherical contact lens optical power equivalent range: +7.75D to −19.25D). Considering health issues, one hundred and five (52%) patients were found to exhibit at least one undiagnosed complication (95% CI: 0.45-0.59): 70% were diagnosed with contact lens driven ocular complications; 54% were diagnosed with non-contact lens driven ocular health issues; and 4% showed signs of undiagnosed systemic disease. Of note, complication prevalence increases to 72% overall if both contact lens fit issues and contact lens care compliance problems are included as complications in analysis. A striking ocular health and contact lens complication rate in asymptomatic soft contact lens wearers is demonstrated across two different study sites. This data suggests that asymptomatic as well as symptomatic contact lens wearers require routine professional evaluations.