Features

Trends in UK contact lens prescribing 2020

Professor Philip Morgan reports on the 25th annual Eurolens Research survey into UK contact lens prescribing

This year marks a quarter of a century of our attempt to characterise the British contact lens market in terms of the types of lenses prescribed by eye care practitioners.1-24 Such information is not generally available so this work intends to inform practitioners, students, researchers and industry alike about the current lens and solution choices made across the country. Since 1996, we have collected detailed information on over 25,000 UK contact lens fits.

Of course, 2020 has been an unusual year for contact lens practice with the Covid-19 lockdown during the second quarter of the year. Most of the responses from this work are received before the end of March and so although this year’s report features a smaller number of lens fits (731) than in recent times, the response is comfortably sufficient for meaningful conclusions to be drawn.

As before, we randomly selected 1,400 optometrists and 600 contact lens opticians from the General Optical Council register and sent each an A4 survey form. For up to 10 contact lens fits, practitioners provided information about the date of fitting, new or refit, age, sex, material, design, frequency of replacement, days per week of wear, daily or extended wear, and care system. Responses were entered into a database of over 400,000 global lens fits and analysed. A weighting system is used to appropriately account for the volume of activity undertaken by the respondents, calculated by the time period required to achieve 10 fits.

This year we received forms from 49 contact lens opticians, 17 optometrists and nine ‘not recorded’. Of all the fits recorded, 66% were to females and the mean age of patients at fitting was 38.7 ± 17.0 years (range seven to 87 years); this average is similar to recent years and is a higher value than generally appreciated across the professions.

Just over half of fits (53%) were described as ‘new fits’ (to patients with no recent experience of contact lenses). Ninety eight percent of patients managed as new fits were prescribed soft lenses compared to 96% of refits (figure 2). Of soft lens wearers, 22% were prescribed lenses for part-time use (three days per week or less) compared to none of those receiving rigid lenses. These proportions have remained broadly constant over the history of this survey work (figure 1).

Figure 2: Major findings from the 2020 survey

Soft lens details

Eighty four percent and 74% of soft lenses prescribed as new fits and refits, respectively, were manufactured from silicone hydrogel materials with the remaining lenses generally mid (40-60%) or high (>60%) water content products (figure 2). For the first time, the most commonly prescribed lens design was a toric. In this work, a fit described as ‘toric’ means one or both lenses in a pair, so this finding means that more single vision patients are now prescribed one or two toric lenses within their lens pair than those receiving two spherical lenses (figure 3). Although this observation is not unexpected given recent trends, it signals a remarkable change to the market; in 1996, 81% of soft lens fits comprised a pair of spherical lenses and only 14% included a toric lens. The other main change in recent times has been the continuous growth of multifocal lenses which now account for close to a quarter of all soft lens fits.

Figure 3: Trends in types of lens

Daily disposables continue their dominance of the UK soft lens market, accounting for over 60% of both new fits and refits. If only new spherical lens fits are considered, the proportion of daily disposables reaches a remarkable 85%. Monthly replaced lenses account for most of the remaining ‘reusable’ lens segment.

For prescribed wearing modality, 0.5% of new fits and 3.9% of refits were prescribed as extended wear. The trend for prescribing a higher proportion of extended wear to refit patients has remained a consistent theme throughout this work, presumably due to practitioners having greater confidence in this form of lens wear for a patient with a history of contact lens use (figure 4). The history of extended wear prescribing peaked around 15 years ago when a number of silicone hydrogel products were released onto the market and it was considered that their improved oxygen supply compared to conventional soft lens materials would ameliorate adverse events associated with earlier waves of extended wear prescribing.

Figure 4: Extended wear fits

Multi-purpose solutions remain the clear first choice of care regimens, prescribed with 96% of soft lens fits.

Rigid lens details

As in previous years, the number of rigid lens fits reported was low and as such, caution is required in interpreting the sub-categories of this lens type. However, it is noteworthy that mid Dk lenses are the most widely prescribed material, and about 6% of rigid lenses were of an orthokeratology design.

Philip Morgan is professor of optometry and director of Eurolens Research at the University of Manchester.

Acknowledgements

In recognition of the 25th annual survey report, the author wishes to thank all his participating UK practitioner colleagues for providing details of their contact lens patients since 1996 and to recognise the ongoing contribution to this work of emeritus professor Nathan Efron. The author also thanks the editorial and other staff at Optician for publishing this work each
year.

References

  1. Morgan PB. UK contact lens prescribing in 2019 Optician 2019; 4 October 2019 14-16.
  2. Morgan PB. 2018 data on UK contact lens prescribing. Optician 2018; 258 (6668) 15-18.
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  4. Morgan PB. The trends in UK contact lens prescribing 2016. Optician 2016; 252 (6573): 14-15.
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  24. Morgan PB, Ramsdale C and Efron N. Trends in UK contact lens prescribing 1996. Optician 1997; 213 (5583): 35-36.