Figure 1: Average age at fitting for soft and rigid lenses. Three year moving averages.
We have managed a survey of the types of contact lenses prescribed in the UK since 1996. The initial intent was to provide information about current practice to colleagues across the country who fit contact lenses to help them benchmark their own habits, and additionally to share data with researchers and industry to inform their own work.
Those initial hopes are still the basis for this long-standing project. The survey has run in the same way over this time, and results have been published each year in Optician.1-27 The database collected over this period holds information about 28,100 contact lens fits and over a quarter of a million individual datapoints about these fits.
In January 2023, printed A4 survey forms were sent to 2,000 optometrists and contact lens opticians selected at random from the GOC register. Recipients were invited to provide the following information about 10 contact lens fits performed after receiving the survey: 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.
Information was provided by completing and returning the paper survey form, or by entering the same information at contactlensprescribing.com. At the time of analysis, a scaling system is applied so that lens fits from busier practices (measured by considering the date range for the 10 reported fits) are afforded a greater weighting than those for less busy respondents.
This year we received information about 885 contact lens fits from 91 respondents who were about two-thirds contact lens opticians with the remainder optometrists. The fitted patients were 63% female with a mean ± standard deviation age of 38.6 ± 17.7 years (with a range from six to 90 years).
Age at fitting has varied considerably since the start of the survey (figure 1). The average age for patients fitted with soft lenses was around 32 years at the turn of the century and this rose steadily to about 39 years in 2018, from which time there has been a small decline.
Age at fitting has always been greater for rigid lens wearers, increasing in the first two decades of the century to the mid-40s before falling back in more recent years. Fifty-four percent of all fits were ‘new fits’ (ie to people with no recent experience of contact lens wear) and 69% of fits were prescribed on a ‘full time’ basis – four days per week of wear or more.
Soft lens fits
Soft lenses continue to dominate UK contact lens fits, accounting for 98% of new fits and 95% of refits (figure 2). Silicone hydrogels account for close to 90% of soft lenses prescribed, with the remainder a mix of low, mid and high water conventional hydrogel materials.
Similar numbers of patients received spherical soft lenses to both eyes (defined as a ‘spherical fit’ in this work) compared to those receiving a toric lens to one or both eyes (a ‘toric fit’).
The types of soft lens designs have changed dramatically since the inception of this survey. Before the turn of the century, around 80% of patients were reported as having a spherical fit (figure 3).
By 2021, the situation was much more diverse, with more toric than spherical fits and a much higher proportion of multifocal fits.
Lenses for myopia control have also increased in recent years. Although these lenses do not feature significantly when lenses to all ages are considered, when lens fits to children (aged 0-14 years) are considered, myopia control is reported as the lens design in 35% of fits.
In terms of lens replacement, daily disposable lenses continue their leading position, accounting for 78% of new fits and 65% of refits in 2023.
Monthly reusable lenses account for almost all of the remaining lenses prescribed. Extended wear lenses account for only 0.3% of fits and multipurpose solutions are prescribed to 96% of patients when solutions are used, with the remainder hydrogen peroxide.
Rigid lens fits
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.
The data received suggests that scleral lenses continue to be a popular choice at 18% of rigid lenses prescribed.
Of corneal lenses, high Dk materials (values over 90 units) are used in about two-thirds of fits. About 60% of rigid lenses in 2023 were prescribed on a planned replacement basis.
- Philip Morgan is professor of optometry and director of Eurolens Research at the University of Manchester.
References
1. Morgan PB. Trends in UK contact lens prescribing Optician 2022; 2 November 2022 12-14.
2. Morgan PB. Trends in UK contact lens prescribing 2021. Optician 2021. 5 November 2021. 12-14.
3. Morgan PB. Trends in UK contact lens prescribing 2020. Optician 2020; 4 September 2020 10-13.
4. Morgan PB. UK contact lens prescribing in 2019 Optician 2019; 4 October 2019 14-16.
5. Morgan PB. 2018 data on UK contact lens prescribing. Optician 2018; 258 (6668) 15-18.
6. Morgan PB. The trends in UK contact lens prescribing 2017. Optician 2017; 252 (6573): 12-14.
7. Morgan PB. The trends in UK contact lens prescribing 2016. Optician 2016; 252 (6573): 14-15.
8. Morgan PB. Trends in UK contact lens prescribing 2015. Optician 2015; 250 (6518): 12-13.
9. Morgan PB. Trends in UK contact lens prescribing 2014. Optician 2014; 248 (6468): 28-29.
10. Morgan PB. Trends in UK contact lens prescribing 2013. Optician 2013; 246 (6418): 16-17.
11. Morgan PB. Trends in UK contact lens prescribing 2012. Optician 2012; 244 (6364): 14-15.
12. Morgan PB. Trends in UK contact lens prescribing 2011. Optician 2011; 242 (6313): 14-15.
13. Morgan PB. Trends in UK contact lens prescribing 2010. Optician 2010; 239 (6255): 34-35.
14. Morgan PB. Trends in UK contact lens prescribing 2009. Optician 2009; 238 (6205): 20-21.
15. Morgan PB. Trends in UK contact lens prescribing 2008. Optician 2008; 235(6154): 18-19.
16. Morgan PB. Trends in UK contact lens prescribing 2007. Optician 2007; 233(6104): 16-17.
17. Morgan PB. Trends in UK contact lens prescribing 2006. Optician 2006; 231(6054): 16-17.
18. Morgan PB, Efron N. Trends in UK contact lens prescribing 2005. Optician 2005; 229(6004): 28-29.
19. Morgan PB and Efron N. Trends in UK contact lens prescribing 2004. Optician 2004; 227(5950): 16-17.
20. Morgan PB, Efron N. Trends in UK contact lens prescribing 2003. Optician 2003; 225 (5904): 34-35.
21. Morgan PB, Efron N. Trends in UK contact lens prescribing 2002. Optician 2002; 223 (5849): 28-30.
22. Morgan PB and Efron N. Trends in UK contact lens prescribing 2001. Optician 2002; 221 (5803): 38-39.
23. Morgan PB and Efron N. Trends in UK contact lens prescribing 2000. Optician 2000; 219 (5749): 22-23.
24. Morgan PB and Efron N. Trends in UK contact lens prescribing 1999. Optician 1999; 217 (5700): 43-44.
25. Morgan PB and Efron N. Trends in UK contact lens prescribing 1998 Optician 1998; 216 (5679): 18-19.
26. Morgan PB and Efron N. Trends in UK contact lens prescribing 1997. Optician 1997; 214 (5630): 32-33.
27. Morgan PB, Ramsdale C and Efron N. Trends in UK contact lens prescribing 1996. Optician 1997; 213 (5583): 35-36.