Trends in UK contact lens prescribing 2009

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In late 1995, Nathan Efron and I bemoaned the lack of publicly available information on the types of contact lenses prescribed by our contact lens colleagues around the UK. We knew that individual companies possessed these sorts of data in detail but they held considerable commercial value and were not available to educators, researchers, clinicians and the contact lens industry generally.

We sought to resolve this absence of information the following year and this effort has been continued each year since and this report outlines the data collected in 2009 which make up the 14th annual survey. Each year we have adopted a standard approach 1,000 practitioners (700 optometrists and 300 dispensing opticians who fit contact lenses) are picked at random from the GOC register and each is sent a questionnaire with a reply-paid envelope to provide information about the first 10 patients fitted with contact lenses after receipt. For each contact lens fit, we capture data about the following: date of fitting, new fit or refit, age and sex of patient, lens material, lens design, frequency of replacement, days per week of wear, modality (daily or extended wear) and care system.

In 2009, completed questionnaires were received from 101 eye care practitioners (58 contact lens opticians, 40 optometrists and three not reported) detailing information about 926 contact lens fits this response is close to the historical average. All reported fits were given a weighting based on the number of lenses fitted per year by the practitioner (based on the date information on the form) so that fits by practitioners conducting many contact lens fits were afforded a higher weighting than those performing fewer fits.

The age of contact lens wearers at fitting is increasing. In 2009, rigid lens wearers were nearly 46 years old on average compared to 37 years for soft lens wearers. These values compare to 34 years and 31 years 10 years ago. As before, women account for most contact lens fits 63 per cent of fits were to females in 2009.

Rigid vs soft lens fits

Rigid lens fits for new wearers have staged a modest revival, standing at 7 per cent of fits in 2009 (Figure 1) compared with less than 3 per cent in 2007. Rigid lens refits continue to fall, however, with this lens type accounting for only 13 per cent of fits in 2009.

Soft lens details

Silicone hydrogels were the most commonly prescribed soft lens material in 2009, surpassing mid and high water content hydrogels for the first time. Low water content lenses are very rarely prescribed now. Spherical lens designs just account for the majority of lens designs prescribed (51 per cent of new fits), with significant numbers of toric lenses as in previous years. There is evidence for increasing use of monovision and multifocal lenses. Examining soft lens fits to patients aged 45 years and over, 50 per cent of lenses were in these two categories this represents a doubling of this rate of fitting since 2003 (Figure 2). Daily and monthly disposable lenses continue to dominate soft lens replacements, with almost no lenses prescribed for a less frequent replacement interval.

There has been a reduction in the proportion of extended wear lenses prescribed at 3 per cent of new fits and 13 per cent of refits. Over 90 per cent of such fits are with silicone hydrogel materials.

Last year saw a marked reduction in the use of multi-purpose solutions for use with soft lenses, to 75 per cent of prescribed care products this year has seen a resurgence to 87 per cent, a similar value to 2004-7. The remaining care system products were all 1-step peroxide regimens.

Rigid lens details

As in previous years, a high proportion of rigid lenses are torics. This suggests a continuation of the recent trend of rigid lenses being used for 'special' rather than standard fitting. High Dk materials remain the most widely prescribed and most rigid lenses are prescribed with a recommended replacement interval.

Acknowledgements

This survey was funded by the sponsors of Eurolens Research: Bausch & Lomb, Abbott Medical Optics (UK), Alcon Laboratories (UK), CIBA Vision (UK), CooperVision , Johnson & Johnson Vision Care, Menicon Co, Sauflon Pharmaceuticals. The author would like to thank the contact lens practitioners who anonymously participated in this survey.

References

1. Morgan PB. Trends in UK contact lens prescribing 2008. Optician, 2008 235(6154): 18-19.
2. Morgan PB. Trends in UK contact lens prescribing 2007. Optician, 2007 234(6104): 16-17.
3. Morgan PB. Trends in UK contact lens prescribing 2006. Optician, 2006 231(6054): 16-17.
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11. Morgan PB and Efron N. Trends in UK contact lens prescribing 1998. Optician, 1998 216 (5679): 18-19.
12. Morgan PB and Efron N. Trends in UK contact lens prescribing 1997. Optician, 1997 214 (5630): 32-33.
13. Morgan PB, Ramsdale C and Efron N. Trends in UK contact lens prescribing 1996. Optician, 1997 213 (5583): 35-36.

? Dr Philip Morgan is director of Eurolens Research at The University of Manchester