‘If it’s in your chair it ain’t rare’ is a phrase that’s never too far away from a contact lens fitter’s mind. It’s no surprise then that anyone prescribing lenses is obsessed with managing risk. That’s eye infection right?

Developments in contact lens technology have transformed comfort and breathability. The daily disposable modality has also had a positive effect on reducing adverse events. While developments have generally been designed to make fitting easier, speed up the process and reduce chair time this poses a problem. The whole process is simple and this reduces the professional input made and time spent talking about boring stuff like handling and hygiene.

Simple fit contact lenses are regularly referred to as a commodity item, and it’s apparent that many wearers buy their lenses online as they might buy printer cartridges or trainers. While printer cartridges invariably don’t work and trainers don’t fit, modern contact lenses are so good they tend to do the intended job.

The fear of risk also means practitioners are still unwilling to get kids into contact lenses and all-to-eager to get presbyopes out of lenses. Recent developments are raising questions about risk. Myopia control has the ability to arrest the development of myopia and thereby reduce problems later in life. Will a non-contact lens wearing child move to a myopia control lens slower than a wearer? No lenses could mean more risk.

At the other end of the age scale are hybrids. These offer a way to keep patients in contact lenses that correct their vision completely. As fitters get into the habit of fitting off the shelf lenses more complex prescriptions could suffer.

How many astigmatic presbyopes are driving around in spherical multifocals? How does the profession measure the risk in that?