For almost two decades, we have reported on the types of contact lenses prescribed by British eye care practitioners to monitor the uptake of new product types in the market, and to give practitioners an overview of the prescribing behaviour of their peers.1-18 This short paper presents our results for 2014.
A key attribute of our annual survey is that we have used the same methods each time. At the beginning of the year we randomly select 1,000 registered practitioners (700 optometrists and 300 contact lens opticians) from the GOC register and send out a single-page A4 questionnaire. The first 10 patients prescribed contact lenses after its receipt are recorded by the practitioner and the form is returned to the Eurolens Research offices in Manchester. We track 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. A weighting system is employed to account for the volume of activity undertaken by the respondents, as judged by the time period required to achieve 10 fits.
This year we received information about 852 contact lens fits from 53 contact lens opticians, 38 optometrists and two undefined practitioners (93 respondents in total). The mean age of fitting was 39.1 ± 16.8 years with a range from seven to 82 years. The mean age at fitting has risen consistently over the past 19 surveys, from about 32 years in 1996 to over 39 years in 2014. As before, the mean age at fitting was higher for rigid lenses (48.9 years) than for soft lenses (38.3 years).
Rigid vs soft lens fits
Rigid lenses remain rarely prescribed as a new fit (3 per cent) although higher numbers are fitted to existing wearers at 8 per cent (Figure 1).
Soft lens details
Silicone hydrogel materials remain the most widely prescribed soft lens type, accounting for 71 per cent of new fits and 80 per cent of refits (ie to patients who are already wearing contact lenses). Low-water content hydrogels are rarely prescribed with mid water lenses prescribed more than high water lenses. In terms of lens design, spherical lenses are now prescribed to around 40 per cent of lens wearers, with torics and multifocals accounting for significant proportions of soft lens fits. The change in prescribing in this area is shown in Figure 2.
The proportion of spherical lenses prescribed has approximately halved over this time period. The major change has been the increasing use of soft toric lenses to a point where the current level is now close to the appropriate level for the prevalence of astigmatism in the population. This probably relates to:
? Greater availability of toric lenses in all materials and replacement modalities and with increasing power and axis ranges
? Improved manufacturing methods delivering greater lens-to-lens consistency which is key with regular lens replacement
? Better practitioner confidence with these lenses as a consequence.
It is evident that the proportion of multifocals has increased throughout the duration of this survey work while the use of cosmetically tinted lenses has fallen.
The prescribed replacement intervals for new soft lens fits remains similar to recent years at close to a 50/50 split between daily disposables and monthly replaced lenses, although 1-2 weekly lenses have a greater proportion of lenses prescribed as refits.
Rigid lens details
The relatively small number of rigid lens fits means that while a detailed breakdown of lens types is of interest, the statistical confidence intervals around each sub-category data point are large, so some caution should be applied when considering individual figures. It is evident that there is a limited amount of orthokeratology practised in the UK and a moderate proportion of rigid lenses are prescribed on a planned replacement basis.
References
1 Morgan PB. Trends in UK contact lens prescribing 2013. Optician, 2013; 246 (6418): 16-17.
2 Morgan PB. Trends in UK contact lens prescribing 2012. Optician, 2012; 244 (6364): 14-15.
3 Morgan PB. Trends in UK contact lens prescribing 2011. Optician, 2011; 242 (6313): 14-15.
4 Morgan PB. Trends in UK contact lens prescribing 2010. Optician, 2010; 239 (6255): 34-35.
5 Morgan PB. Trends in UK contact lens prescribing 2009. Optician, 2009; 238 (6205): 20-21.
6 Morgan PB. Trends in UK contact lens prescribing 2008. Optician, 2008; 235(6154): 18-19.
7 Morgan PB. Trends in UK contact lens prescribing 2007. Optician, 2007; 233(6104): 16-17.
8 Morgan PB. Trends in UK contact lens prescribing 2006. Optician, 2006; 231(6054): 16-17.
9 Morgan PB, Efron N. Trends in UK contact lens prescribing 2005. Optician, 2005; 229(6004): 28-29.
10 Morgan PB and Efron N. Trends in UK contact lens prescribing 2004. Optician, 2004; 227(5950): 16-17.
11 Morgan PB, Efron N. Trends in UK contact lens prescribing 2003. Optician, 2003; 225 (5904): 34-35.
12 Morgan PB, Efron N. Trends in UK contact lens prescribing 2002. Optician, 2002; 223 (5849): 28-30.
13 Morgan PB and Efron N. Trends in UK contact lens prescribing 2001. Optician, 2001; 221 (5803): 38-39.
14 Morgan PB and Efron N. Trends in UK contact lens prescribing 2000. Optician, 2000; 219 (5749): 22-23.
15 Morgan PB and Efron N. Trends in UK contact lens prescribing 1999. Optician, 1999; 217 (5700): 43-44.
16 Morgan PB and Efron N. Trends in UK contact lens prescribing 1998. Optician, 1998; 216 (5679): 18-19.
17 Morgan PB and Efron N. Trends in UK contact lens prescribing 1997. Optician, 1997; 214 (5630): 32-33.
18 Morgan PB, Ramsdale C and Efron N. Trends in UK contact lens prescribing 1996. Optician, 1997; 213 (5583): 35-36.
Philip Morgan is Professor of Optometry and Director of Eurolens Research at The University of Manchester