Aftab Aslam and you'll reap the benefits
Almost all the population will need some form of vision correction for some tasks at some stage during their lives. Yet surprisingly little is known about how the vision-corrected feel about their choice of correction, their wearing habits or what motivates their purchasing decisions.
To understand the opportunities and barriers around contact lens and spectacle use across Europe, a number of studies of consumer behaviour have been carried out. The aim is to help practitioners learn more about what patients want and expect from their vision correction in order to better meet their individual needs.
Among these studies were two large-scale double-masked consumer surveys: an initial survey in the UK in April 2012, followed by further surveys in Germany, Italy, Poland and Russia in June and July 2012. These were online surveys of independent panels of consumers aged 16-64 years.1
In total, 11,873 interviews were conducted comprising 9,208 contact lens wearers (1,161 in the UK) and 2,665 spectacle wearers (259 in the UK). The interviews explored satisfaction with vision correction, wearing habits and annual spend on vision care. Their motivations when choosing contact lenses were also probed.
More similar than different
Overall, it was found that consumers are more similar than they are different across the five countries. Although the markets are very diverse in terms of structure, regulation and professional responsibilities, consumer attitudes are remarkably consistent for such issues as the relative spend on vision care between spectacles and contact lenses, and wearing behaviour. In other words, consumers are consumers wherever they live.
Across all countries, consumers’ satisfaction with their spectacles is relatively high, 82 per cent saying they agree (agree strongly or agree) that they are satisfied. But looking behind the overall ratings shows that consumers are often less than happy with spectacles as a method of vision correction.
As many as 58 per cent agree strongly or agree ‘I don’t like wearing spectacles but have to’, 32 per cent agree ‘I don’t like the way I look in spectacles’ and 43 per cent agree they find spectacles inconvenient.
Among teens (aged 16 to 19 years), the figure for not liking the way they look in spectacles increases by several percentage points (to 39 per cent).
Striking omissions
More striking still is that spectacles-only wearers are surprisingly likely to leave their correction off for many everyday activities and occasions, and much more so than those who wear contact lenses (Figure 1).
While a relatively small proportion of the population – 6 per cent of spectacle wearers against only 1 per cent of contact lens wearers – use no vision correction at work or at school, the figures for other activities are noticeably high and in each case much higher for spectacles.
Differences in use between the methods of correction are especially marked for sports and relaxing at home, but also for socialising, carrying out chores and simply going ‘out and about’. Again, the proportions of teens who do not wear their vision correction for these activities are greater still.
Although this survey did not ask specifically about driving, research by insurance company Liverpool Victoria in 2010 revealed that as many as 1.1m drivers in the UK admit to driving without their prescribed spectacles.2
Dual wearers
In most of the countries surveyed, very few contact lens wearers only wear contact lenses. In the UK, 80 per cent of contact lens users are ‘dual wearers’ who also wear spectacles and as many as 90 per cent in Italy are dual wearers (Figure 2).
Dual wearers change their spectacles at a similar frequency (±2 months), spend the same amount of money when they buy spectacles and are more likely than spectacles-only wearers to buy other products such as non-prescription sunglasses. As a result, dual wearers spend more on vision care overall than do spectacles-only wearers (Table 1).
In all countries, spending per annum is at least three times greater among dual wearers and up to more than four to five times greater in Russia and Poland. Note that UK spend data do not include non-prescription sunglasses but are likely to be around Germany and Italy levels, close to the average of 3.73 times greater.
These findings add to those of the EASE study which showed that using contact lenses as an aid to spectacle dispensing not only encourages patients to wear contact lenses but also to spend more on their spectacles.3
Driving factors
Practitioners often assume that price is a primary consideration for the patient buying contact lenses. Yet when asked which factors are important to them when choosing a contact lens – and which is the single most important factor – contact lens wearers usually cite aspects of performance rather than price (Figure 3).
In fact only 5 per cent view ‘the lowest price’ as most important. Also, the survey also found that contact lens considerers, on average, think lenses cost 42 per cent more than wearers say they do (8,047 contact lens wearers and 717 contact lens considerers in Germany, Italy, Poland and Russia).The core factors driving contact lens choice are lack of dryness, end of day comfort, overall vision quality and health.
Research also found that UK contact lens wearers are willing to pay extra for better performance from their lenses (Figure 4). Two thirds would pay more for a contact lens which performed better than their current lens for keeping the eye healthy and, on average, they would pay an extra £6.24 for the added benefit.
For improved comfort, that figure rises to £6.66 per month. For better UV protection, less readily appreciable in the short term but an important long-term benefit, wearers would pay an average of £5.29 a month more.
Segmenting shoppers into those who are time driven, health driven, value driven and price driven can help in tailoring practice strategies to meet differing needs, and shows that only a minority of consumers (11 per cent) are driven by price.4
Preference in presbyopes
A recent study shed more light on patient perceptions of different methods of correction in different situations.5 In this study, 27 presbyopes were randomly dispensed progressive addition spectacles (Varilux Comfort) or multifocal contact lenses (Acuvue Oasys for Presbyopia) each for one week of wear. Patients were then dispensed both options to wear for two weeks as and when each modality felt appropriate, and kept a diary of their experiences.
After trying each vision correction option, 11 per cent of the presbyopes chose the spectacles and 11 per cent chose the contact lenses as the best at meeting their vision needs. But the overwhelming preference, at 78 per cent, was for the combination of both correction methods.
The study showed that whereas presbyopes prefer progressive addition spectacles for stationary and solitary activities that require precise vision, multifocal contact lenses are preferred for social and active pursuits since they provide a wider field of view and a more natural vision experience.
Patients perceive the benefits of the two modalities as complimentary and are able to choose between them effectively based on the time, place and activity throughout the day. Practitioners can better satisfy their presbyopic patients’ needs by prescribing both forms of correction.
Emotional versus functional
To dig deeper into the drivers and barriers to spectacles and contact lens use in a younger age group, 12 focus groups were conducted across Europe among adults aged 18-24 years who either currently wore spectacles or who required vision correction but did not currently use any type of correction.6 None had ever worn contact lenses.
Although many of the drivers to using contact lenses could be termed ‘functional’, such as providing unrestricted vision, consumers often cited ‘emotional’ responses – ‘feeling free’, ‘feeling self-confident’, ‘feeling smart’ and ‘hiding their imperfections’ – as driving their interest in contact lenses.
Emotional barriers to spectacle use were often the opposite of these contact lens drivers. Lack of self-confidence, ‘feeling inward, anti-social’ and ‘feeling inadequate because of a weakness or defect’ were among the responses. Engaging with these emotions can help break down the barriers to wearing contact lenses.
But perceptions of spectacles in this age group could also be positive. Among the drivers to wearing them were ‘make me look more fashionable’ and ‘make me look smarter and more professional’. The ‘style element’ is clearly a factor in spectacle wear and the desire for different looks for different occasions adds further weight to the case for dual wear.
Delight your patients
This research shows the importance of considering consumers’ emotional as well as functional needs, and highlights the opportunities to ‘delight’ patients with their vision correction.
Think contact lenses and spectacles, rather than contact lenses or spectacles. The vast majority of contact lens wearers wear both, continue to purchase both and spend the same amount of money on both. Dual wear is valuable both to your patients and to your practice.
Many patients feel they wear spectacles only because they feel they have to. Coupled with low levels of practitioner-driven interest in trialing contact lenses, it is probably not putting the case too strongly to say that large numbers of people needing vision correction feel ‘trapped’ in spectacles.
When a patient presents in your consulting room, make sure you offer a combination of methods of vision correction ‘individualised’ to their work, school and leisure activities. Give them the chance to use their eyewear when and where they need it and in the way that they want.
Use your knowledge of the barriers and drivers to wearing contact lenses to appeal to their emotions. Choose emotional words in your discussion such as ‘freedom’ and ‘confidence’, and talk about how they feel about their appearance.
With contact lenses, price is a less important factor for the patient than some might expect. Have a full and frank discussion with each patient about their priorities and then discuss price in the context of products that meet those requirements and the benefits that a particular lens can provide.
More importantly, as well as adding greater financial value to your business, prescribing contact lenses and spectacles provides a better way of addressing patients’ needs and ensuring they have optimum vision at all times. Remember that, on many occasions, contact lens wearers are much more likely than spectacle wearers to use their correction than leave it off.
The ability to understand consumer behaviour and lifestyle needs, then deliver a portfolio of solutions rather than a simple choice between spectacles or contact lenses, is a hugely powerful tool. Why not use it so that your patients and your business benefit?
If your patients are not offered contact lenses but are aware that they exist, how would they feel about you and your practice? ?
References
1 Aslam A, Sulley A and Packe R. Habits of contact lens and spectacle wearers and their attitudes to vision correction. BCLA Conference paper presentation, June 2013.
2 Survey commissioned by Liverpool Victoria Insurance Company, UK, 2010.
3 Atkins NP, Morgan SL and Morgan PB. Enhancing the Approach to Selecting Eyewear (EASE): A multi-centre, practice-based study into the effect of applying contact lenses prior to dispensing. Cont Lens Ant Eye, 2009;32:3 103-107.
4 Shopper Segmentation Study EMA. Johnson & Johnson Vision Care, 2013.
5 Neadle S, Ivanova V and Hickson-Curran S. Do presbyopes prefer progressive spectacles or multifocal contact lenses? Cont Lens Ant Eye, 2010;33:262-263.
6 Contact Lens Category Campaign Evaluation. YouGov/Johnson & Johnson Vision Care, 2011.
? Aftab Aslam is customer strategic insights director Europe, Middle East and Africa at Johnson & Johnson Vision Care