Trends in UK contact lens prescribing 2022

Understanding the types of contact lenses prescribed in the United Kingdom is potentially useful for a range of stakeholders in the contact lens community.

For prescribing eye care professionals (ECPs) – primarily contact lens opticians and optometrists in the UK – data acts as a benchmark of individual clinical approaches. A comparison to national prescribing trends might show that an ECP fits more rigid lenses than average, is using more soft multifocal fitting or lenses for myopia management than the norm or is perhaps under-indexed in their use of soft toric lenses or silicone hydrogel materials. In some cases, there could be good reason an ECP is not fitting an average distribution of contact lens types, but in other instances, such information might cause a reflection of clinical practice and changes to their approach to contact lenses in general and prescribing behaviour in particular.

For researchers, such information helps put their work into some sort of ‘real world’ context, helping to highlight the likely significance of their endeavours. For educators, a good understanding of the contemporary contact lens marketplace may steer their work. For example, in 2021, Optician reported the uptick in soft lenses prescribed for myopia management in the UK, which suggests current student groups need to be well-informed about this relatively recent introduction to the contact lens landscape in order to work successfully in modern contact lens practice.

For the contact lens industry, these statistics contribute to the general outlook of the market and would likely influence companies’ decision-making of professional services and marketing initiatives and other activity.

The Eurolens Research survey of UK prescribing has run annually since 1996 and has been published in Optician each year.^1-26 Our methodology has remained almost identical over this period. As such, in early January 2022, 2,000 printed A4 forms were sent to 1,400 optometrists and 600 contact lens opticians, to addresses selected at random from the General Optical Council register. Recipients were invited to record information about the first 10 contact lens patients fitted with lenses after receiving the form. 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 was noted on each form before it was returned to the University of Manchester via post or email for processing. A weighting system is used so that fits from busier practitioners (fitting a greater volume of lenses) are afforded a greater weight than less contact lens active colleagues. A small number of ECPs opted to provide the same information via an online version of the survey at contactlensprescribing.com.

Figure 2: Soft lens designs prescribed to children aged 14 years or younger

This year, we received information about 672 contact lens fits from 52 contact lens opticians and 17 optometrists (and one ‘not recorded’ colleague). Sixty-five percent of fits were to female patients (almost exactly hitting the ‘two thirds/one third’ informal rule of contact lens practice) and the mean ± standard deviation age was 37.3 ± 18.0 years.

Overall, lens fits were recorded for patients from seven to 80 years old. Sixty percent of all fits were ‘new fits’ (on people with no recent experience of contact lens wear) and 70% of fits were prescribed on a ‘full-time’ basis (four days per week of wear or more).

Soft lens fits

As seen in recent years, soft contact lenses are dominant in the UK market; 97% of new fits and 90% of refits were with this lens type (figure 1). Silicone hydrogels (Si-H) accounted for more than 80% of fits, with mid-water content materials the most popular type of ‘conventional’ hydrogel. The increase in the popularity of silicone hydrogels is shown clearly in figure 2. This material was launched in the UK in 1999 as an extended wear product Bausch + Lomb PureVision and CIBA Vision Night & Day, and, from 2004, was marketed primarily for daily wear like the Johnson & Johnson Acuvue Advance. The latter introduction saw a great increase in the use of silicone hydrogels such that for ‘reusable’ soft lenses the rate of use is now around 90%; slightly reduced prescribing of silicone hydrogel materials is reported for daily disposable products.

In recent years, similar numbers of patients received at least one toric lens in their prescribed lens pair, compared with those given two spheres. Multifocals account for a very healthy 21% of new fits and 25% of refits, with smaller numbers of lenses prescribed as monovision, cosmetic tints and myopia control. Daily disposable lenses are the most widely prescribed replacement option in the UK, resulting in 79% of new fits and 66% of refits. Monthly replaced lenses are the most widely prescribed reusable option. Figure 3 shows that a significant proportion of daily disposable lenses are prescribed for part-time (three days per week or fewer) use; they are an excellent option for social wear, sports, and other occasional activities.

Inspection of this figure suggests that this proportion has decreased slightly in the past quarter of a century, although it is still much higher than for reusable lenses. The ‘cost per wear’ is likely to play a role here.²⁷

Figure 3: Soft lens replacement intervals 1996-2021

Less than 0.3% of new fits and 2% of refits were reported for extended wear. Ninety-seven percent of patients fitted with soft lenses were prescribed a multipurpose solution, with the remaining 3% recommended a peroxide option.

Rigid lens fits

As in previous years, the number of rigid lens fits reported was low and, therefore, caution is required in interpreting the sub-categories of this lens type. More scleral lenses were fitted than in previous years (29% of rigid lens new fits and 17% of refits) – a trend that hints at a growing use of this lens type in the UK. About half of rigid lenses in 2022 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 2021. Optician 2021. 5 November 2021, 12-14.
2. Morgan PB. Trends in UK contact lens prescribing 2020. Optician 2020; 4 September 2020, 10-13.
3. Morgan PB. UK contact lens prescribing in 2019 Optician 2019; 4 October 2019, 14-16.
4. Morgan PB. 2018 data on UK contact lens prescribing. Optician 2018; 258 (6668): 15-18.
5. Morgan PB. The trends in UK contact lens prescribing 2017. Optician 2017; 252 (6573): 12-14.
6. Morgan PB. The trends in UK contact lens prescribing 2016. Optician 2016; 252 (6573): 14-15.
7. Morgan PB. Trends in UK contact lens prescribing 2015. Optician 2015; 250 (6518): 12-13.
8. Morgan PB. Trends in UK contact lens prescribing 2014. Optician 2014; 248 (6468): 28-29.
9. Morgan PB. Trends in UK contact lens prescribing 2013. Optician 2013; 246 (6418): 16-17.
10. Morgan PB. Trends in UK contact lens prescribing 2012. Optician 2012; 244 (6364): 14-15.
11. Morgan PB. Trends in UK contact lens prescribing 2011. Optician 2011; 242 (6313): 14-15.
12. Morgan PB. Trends in UK contact lens prescribing 2010. Optician 2010; 239 (6255): 34-35.
13. Morgan PB. Trends in UK contact lens prescribing 2009. Optician 2009; 238 (6205): 20-21.
14. Morgan PB. Trends in UK contact lens prescribing 2008. Optician 2008; 235(6154): 18-19.
15. Morgan PB. Trends in UK contact lens prescribing 2007. Optician 2007; 233(6104): 16-17.
16. Morgan PB. Trends in UK contact lens prescribing 2006. Optician 2006; 231(6054): 16-17.
17. Morgan PB, Efron N. Trends in UK contact lens prescribing 2005. Optician 2005; 229(6004): 28-29.
18. Morgan PB and Efron N. Trends in UK contact lens prescribing 2004. Optician 2004; 227(5950): 16-17.
19. Morgan PB, Efron N. Trends in UK contact lens prescribing 2003. Optician 2003; 225 (5904): 34-35.
20. Morgan PB, Efron N. Trends in UK contact lens prescribing 2002. Optician 2002; 223 (5849): 28-30.
21. Morgan PB and Efron N. Trends in UK contact lens prescribing 2001. Optician 2002; 221 (5803): 38-39.
22. Morgan PB and Efron N. Trends in UK contact lens prescribing 2000. Optician 2000; 219 (5749): 22-23.
23. Morgan PB and Efron N. Trends in UK contact lens prescribing 1999. Optician 1999; 217 (5700): 43-44.
24. Morgan PB and Efron N. Trends in UK contact lens prescribing 1998. Optician 1998; 216 (5679): 18-19.
25. Morgan PB and Efron N. Trends in UK contact lens prescribing 1997. Optician 1997; 214 (5630): 32-33.
26. Morgan PB, Ramsdale C and Efron N. Trends in UK contact lens prescribing 1996. Optician 1997; 213 (5583): 35-36.
27. Efron SE, Efron N, Morgan PB, Morgan SL. A theoretical model for comparing UK costs of contact lens replacement modalities. Contact Lens and Anterior Eye 2012 35: 28-34.